Employees of Small Businesses Hoping to Abandon E-R as Doctor

From the Public News Service:

WEST HARTFORD, Conn. – A small business owner in West Hartford says learning that none of his employees had their own doctor and used the hospital emergency room for their health care was a wake-up call for him to push for health reform in Connecticut.

The Presence of Outcome Bias in Emergency Physician Retrospective Judgments of the Quality of Care

From the Annals of Emergency Medicine:

Study objective: In peer review and malpractice litigation, biased assessment of the quality of care can have a profound effect. We determine the effect of knowledge of outcome on emergency physicians’ ability to assess care quality.

Methods: Emergency physicians completed a Web-based survey containing 6 case scenarios written to fall along a spectrum of quality of care. Participants were randomized to receive either no case outcomes or a mixture of good and bad outcomes. For each scenario, participants rated the quality of care categorically (poor, below average, average, good, outstanding) and on a 0- to 100-point scale. We examined how the scenario’s outcome affected judgments about the quality of the process of care and whether certain individuals are more prone to outcome bias.

Results: Five hundred eighty-seven participants completed the survey. For each scenario, quality ratings were highest when the outcome was good and lowest when the outcome was bad. The difference between ratings for “good outcome” and “no outcome provided” was bigger than the difference between “no outcome provided” and “bad outcome.” In cases of intermediate quality, outcome bias shifts ratings by a magnitude equivalent to 1 qualitative step in quality (eg, from good to average). The outcome bias effect is smaller for scenarios for which care is unambiguously good or bad. We found no evidence that outcome bias was concentrated in individuals.

Conclusion: Emergency physicians demonstrate outcome bias in cases of intermediate quality more than in cases in which the quality of care is clear. Outcome bias tends to inflate ratings in the presence of a positive outcome more than it penalizes scenarios with negative ones.

Super Bowl may trigger heart attacks

From CNN:

This Sunday’s Super Bowl could prove to be a real heartbreaker for some fans of the losing team.

A new study suggests that the emotional stress fans feel after a loss may trigger fatal heart attacks, especially in people who already have heart disease.

In the study, which was published Monday in the journal Clinical Cardiology, researchers analyzed death records in Los Angeles County for the two weeks after the 1980 and 1984 Super Bowls, both of which featured teams from Los Angeles. (The game days were included.) Then, as a control, the researchers looked at the same data from the corresponding days in the intervening years.

Wall Street Journal Seeks Right to Publish Physician Medicare Billing Information

From MedPage Today:

The Wall Street Journal has filed suit to overturn a ban of more than 30 years on publication of Medicare payment amounts to individual physicians by name, citing a need for independent scrutiny of potential fraud.

Although media organizations are allowed access to Medicare payment records, they have been barred from publishing them. A federal court in Jacksonville, Fla., ruled in 1979 that publishing such information would violate physicians’ privacy. It issued a permanent injunction that amounts to a gag order.

Making an appointment for the emergency room a growing trend

From the Los Angeles Times:

Eight Southern California hospitals have signed up for a system called InQuickER that lets patients pay a fee of $14.99 to $24.99 to set up an appointment online for emergency care. If they’re not seen within 15 minutes, they get their money back.

NYT Prime Number: Shoveling Injuries

From the New York Times:

11,500: The average annual number of people treated in hospital emergency rooms from 1990 to 2006 for injuries suffered while shoveling snow, a study in this month’s issue of The American Journal of Emergency Medicine reports. Men were most frequently hurt. Injuries to the lower back accounted for slightly more than one-third of emergency room visits. Twenty percent of the injuries were the result of slips and falls; 15 percent, from being struck by a shovel. Nearly 7 percent of the visits were “ cardiac-related,: including all 1,647 deaths.

Resolution in conflict between ED group and Alaska hospital

From the Fairbanks Daily News-Miner:

Tanana Chiefs Conference and the independent operator of the emergency room at Fairbanks Memorial Hospital have reached an agreement that has led to the dismissal of a lawsuit against TCC.

The lawsuit, filed in January 2010, alleged TCC was under-paying or refusing to pay for care Alaska Natives receive in the hospital’s emergency room.

The lawsuit, filed by a Washington state-based lawyer on behalf of Golden Heart Emergency Physicians, was seeking restitution for “thousands of unfair acts” allegedly made by TCC.

Golden Heart provides emergency medical care at the hospital, but its doctors and nurses are not employed by the hospital.