New Jersey’s emergency rooms clogged by people lacking health insurance

From NJ:

Too many people lacking health insurance or who do not regularly visit doctors are clogging Trenton emergency rooms and hospitals, costing tens of millions of dollars a year that could be saved through more efficient health care, a Rutgers University study found.

The capital ranked third worst among New Jersey cities in the study by Rutgers’ Center for State Health Policy that found that between 2008 and 2010, avoidable emergency room visits alone cost $16.5 million a year. Avoidable hospitalizations cost another $23 million.

Payment Adjustments for Low-Volume Hospitals and Medicare-Dependent Hospital Program Extended

From JD Supra:

CMS has issued a notice that (1) payment adjustments for certain low-volume hospitals and (2) the Medicare-dependent hospital (MDH) program will be extended through federal fiscal year 2013 (FY 2013). The extension of the low-volume payment adjustment and the MDH program were mandated by the American Taxpayer Relief Act of 2012. In most cases, the adjustments will be applied to reimbursement for discharges that occur between October 1, 2012 and September 30, 2013

Legislators Consider Bills To Change Malpractice Law

From the Hartford Courant:

Two bills related to medical malpractice are making their way through the legislature – one that would make it easier to sue a physician and one that would make it more difficult.

Two bills that would change medical malpractice laws are making their way through the legislature: one to make it easier to sue a physician, and one to make it more difficult.

A public hearing of the judiciary committee will be held Monday on a bill that would lessen the requirement for filing such a suit. Current law requires that a plaintiff receive the signature of a “similar health care provider” stating that the case is a valid one. The proposal would change “similar” to “qualified.”

Pain Pill Checks Argued

From the News Telegram:

Health care regulations in Massachusetts have had, since 1992, a database of prescriptions written and dispensed for drugs that are susceptible to abuse, called a prescription monitoring program. The voluntary database went online in 2010 and covers drugs under federal schedules II through V, which includes everything from oxycodone/OxyContin to Ritalin, to cough medicine with codeine. 

Now, proposed regulation amendments by the state Department of Public Health’s Bureau of Health Care Safety and Quality would require all physicians, dentists and podiatrists to log into the database before seeing any new patient. 

The proposal, which was the subject of a public hearing in Boston last week, has received criticism from doctors who think the prescription monitoring database is useful but the requirement to check every new patient — defined as a patient whom the prescriber hasn’t seen in 12 months — will unnecessarily add administrative time and expense to medical care.

Tiny Blood Monitor Tells Your Smartphone When You’re about to Have a Heart Attack

From Neatorama:

Doctors can implant his tiny sensor package developed by researchers at the Ecole Polytechnique Fédérale de Lausanne in Switzerland. A battery worn on a patch outside of the body gives it energy. When sensors detect chemical indicators of a heart attack, the system sends a warning to a Bluetooth-enabled device, such as a smartphone

ER doctors continue campaign for emergency room funding

From CBC News:

Since the beginning of March, B.C.’s emergency room doctors have posted 19 videos online, airing their grievances and calling for an extra $10 million of funding from the province.

U.S. hospitals improving stoke, heart care

From UPI:

For-profit U.S. hospitals are outperforming other hospitals when treating stroke, heart attack and pneumonia patients in emergency rooms, researchers say.

The new, mandatory Hospital Inpatient Value-Based Purchasing Program, which went into effect last October, provides financial rewards or penalties based on achievement or improvement on several publicly reported quality measures.

Dr. Rahul Khare of Northwestern University’s Feinberg School of Medicine and an emergency medicine physician at Northwestern Memorial Hospital said the for-profits were more likely to receive bonuses under Medicare’s new payment rules, but non-profit and public are making noticeable improvements and many might be eligible for bonuses, too.

Injured woman raped in emergency room; worker charged

From the Post Intelligencer:

A former Highline Medical Center worker has been charged with rape following allegations that he attacked a patient being treated there for a separate attack.

King County prosecutors contend emergency room technician Anthony R. Sims anally raped an injured woman who was being treated at the Burien hospital in January 2012. Investigators contend recently processed DNA evidence backs the woman’s account.

Don’t Get Sick on the Weekend

From Emergency Medicine Literature of Note:

Quite bluntly, you’re more likely to die.

“Don’t get sick on the weekend: an evaluation of the weekend effect on mortality for

patients visiting US EDs”: www.ncbi.nlm.nih.gov/pubmed/23465873

The Costs of Emergency Room Cost-Cutting

From the New York Times:

For close to 50 years, emergency rooms have been fingered as a major source of excessive health care costs. And while some newer research has challenged the idea that a large proportion of patients visit the emergency room for routine problems, many payers and policy makers continue to focus on these patients as a major source of wasteful spending.

Not long ago, for example, in an effort to cut back on Medicaid expenditures, several states zeroed in on these so-called “unwarranted visits” and proposed a policy so apparently logical that it was hard to resist the temptation to slap yourself on the forehead. The proposal was to reimburse for an emergency room visit based on the urgency of the discharge diagnosis.

Bills would be paid for true emergencies, like a heart attack or ruptured aneurysm. But payment would be reduced or denied for visits that turned out to be less serious, like heartburn, constipation or an insect bite.

It sounded like an obvious way to discourage unnecessary and expensive visits to the E.R.

But according to the new study, published in The Journal of the American Medical Association, such a policy relies on a huge, and erroneous, assumption: that patients can predict the urgency of their diagnosis based on initial symptoms alone.