Hospital Costs Outsized for ‘Frequent Flier’ Kids

From MedPage Today:

A substantial proportion of pediatric hospitalizations and costs accrue to a small percentage of children who are readmitted frequently, researchers found in a study of children’s hospitals.

The 2.9% of kids with frequent readmissions accounted for 18.8% of overall admissions and 23.2% of all inpatient charges at the 37 hospitals studied, Jay G. Berry, MD, MPH, of Children’s Hospital Boston, and colleagues reported in the Feb. 16 issue of the Journal of the American Medical Association.

Does the Rural Trauma Team Development Course Shorten the Interval From Trauma Patient Arrival to Decision to Transfer?

From the Journal of Trauma:

Background: The Rural Trauma Team Development Course (RTTDC) was developed by the ad hoc Rural Trauma Committee of the American College of Surgeons, Committee on Trauma to address the increased mortality of the rural trauma patient. The effectiveness of the RTTDC in shortening the interval from patient arrival to decision to transfer and the effect on the transfer process of communication training emphasizing team building is the focus of this study.

Method: Rural level III and level IV trauma centers (N = 18) were enrolled in a multiinstitutional 3-month longitudinal study of transferred trauma patients. Results were compared with institutions having hosted RTTDC versus those institutions not yet exposed to the course.

Results: One-way analysis of variance was conducted. Results indicated that RTTDC training alone and RTTDC including communication training resulted in a statistically significantly shorter (p < 0.05) time for decision to transfer. Transferring squad arrival time was also significantly reduced (p < 0.01) as was the number of transferring squads contacted (p < 0.01). No differences were observed among the trauma facilities and the number of receiving facilities contacted, (p = 0.64) or in the time required to find an accepting facility (p = 0.72).

Conclusion: The RTTDC alone and with the embedded communication module significantly reduce delays in the transfer process of the rural trauma patient.

The role and impact of the physician assistant in the emergency department

From Emergency Medicine Australasia:

This systematic review describes the role and impact of physician assistants (PAs) in the ED. It includes reports of surveys, retrospective and prospective studies as well as guidelines and reviews. Seven hundred and twelve studies were identified of which only 66 were included, and many of these studies were limited by methodological quality. Generally the use of PAs in the ED is modest with 13-18% of US EDs having PAs although academic medical centres report PA use in 65-68% of EDs. The evidence indicates that PAs are reliable in assessing certain medical complaints and performing procedures, and are well accepted by ED staff and patients alike. There is limited evidence as to whether PAs improve ED flow or are cost-effective. Future studies on work processes, cost-effectiveness, unfamiliar patients’ willingness to be treated by non-physician providers, and ED physicians’ acceptability of PAs are needed to inform and guide the integration of PAs into EDs.

Why Emergency Docs Test for Illegal Drugs Without Their Consent

From Time:

Do you know that when you walk into an emergency department, your doctor may run a test for illicit-drug use without telling you?

Yes, this is something we can and often do. And in many cases, it’s done for a good reason.

Video shows Oregon hospital acted quickly in emergency

From Reuters:

Surveillance video shows that a hospital criticized for a slow response acted correctly in quickly sending a paramedic to help a man who crashed his car and died in the hospital parking garage while trying to get to the emergency room.