Dumping Dental Coverage From Medicaid Doubled Idaho’s Dental-Related ER Visits

From Boise State Public Radio:

Trying to reduce Medicaid’s dental expenses has been like pulling teeth.

That’s what Department of Health and Welfare officials said Tuesday, describing how a decision in 2011 to dump dental coverage for 27,000 adults led to a doubling of dental-related emergency room services.

Health system trying to figure out why there’s a surge in uninsured patients in their ED’s

From the Miami Herald:

Officials at Jackson Health System say they do not know what has caused a surge of uninsured patients to flood emergency rooms in the past few months, leading to nearly a $1 million loss for December.

On Wednesday, the Public Health Trust that runs Jackson asked hospital administrators for weekly updates on the influx of uninsured. The change in the financial picture could potentially threaten the success story pitched last fall to Miami-Dade voters, who approved $830 million in taxpayer financing to upgrade the county’s aging hospital network.

Jackson executives said they’re monitoring patient admissions daily to better understand what’s driving the greater numbers of uninsured, who are being admitted largely through the hospital system’s emergency rooms at the main campus in Miami and at the satellite in South Miami-Dade.

Should ED Wait Time Billboards Go Blank?

From HealthLeaders Media:

The hospital marketing tactic of promoting short emergency department wait times is out of step with the swift changes in the healthcare industry.

Through billboards, websites, and mobile apps, hospitals have been promoting their speedy ED wait times to patients. In fact, new tools to help them do so are already making headway in the new year.

 

Former Cowboy Josh Brent claims his rights were violated during blood draw in the ED

From the Dallas News:

Former Dallas Cowboy Josh Brent complained that his rights were being violated during a mandatory blood draw after his deadly crash on Dec. 8, 2012, audio recordings played Tuesday during his intoxication manslaughter trial revealed.

In the recordings played for jurors, Brent expressed frustration that he was taken to a hospital against his will and that three vials of blood were collected.

“I have no rights as an American citizen right now,” Brent said at one point.

Officers arrived and eventually took Brent to a hospital to draw blood. On the way, he told officers that because he had an out-of-state driver’s license, he was exempt from Texas law. They repeatedly told him that wasn’t true.

Life years saved, standardised mortality rates and causes of death after hospital discharge in out-of-hospital cardiac arrest survivors

From the Emergency Medicine Journal:

Aim of the study: Out-of-hospital cardiac arrest (OHCA) accounts for many unexpected deaths in Europe and the survival rates in different regions vary considerably. We have previously reported excellent survival to discharge rates in the Stavanger region. We now describe the long-term outcome of OHCA victims in our region.

Methods: In this retrospective observational study, we followed all OHCA hospital discharge survivors between 01.07.2002 and 30.06.2011 (n=213) for a minimum of 1 year and up to 10 years. Based on the national death statistics stratified for gender and age, we could calculate the potential life years saved, standardised mortality rates (SMR) and delineate the causes of death after hospital discharge.

Results: Of the 213 patients who were discharged from the hospital, 91% had a cardiac origin of their OHCA. The mean potential life years saved per patient was 22.8 years. The observed five-year survival rate was 76%. The overall SMR in our study cohort was 2.3 when compared to the age- and gender-matched population. Cardiac disease was a prominent cause of late deaths, with the specific SMR for cardiac disease-related deaths being as high as 42 in males and 140 in females.

Conclusion: Resuscitation of OHCA victims lead to a significant long-term benefit with respect to life years saved. Cardiac disease was the main cause of death after hospital discharge. More studies are needed to identify the potential of therapeutic interventions and rehabilitation efforts that may further enhance the long-term outcomes in OHCA hospital discharge survivors.

Chest compression depth after change in CPR guidelines–improved but not sufficient

From Resuscitation:

Aims

Cardiopulmonary resuscitation is one of the most vital therapeutic options for patients with cardiac arrest. Sufficient chest compression depth turned out to be of utmost importance to increase the likelihood of a return of spontaneous circulation. Furthermore, the use of real-time feedback-systems for resuscitation is associated with improvement of compression quality. The European Resuscitation Council changed their recommendation about minimal compression depth from 2005 (40mm) to 2010 (50mm). The aim of the present study was to determine whether this recommendation of the new guidelines was implemented successfully in an Emergency medical service using a real-time feedback-system and to what extend a guideline-based CPR training leads to a “change in behaviour” of rescuers, respectively.

Methods and Results

The electronic resuscitation data of 294 patients were analysed retrospectively within two observational periods regarding fulfilment of the corresponding chest compression guideline requirements: ERC 2005 (40mm) 01.07.2009–30.06.2010 (n=145) and ERC 2010 (50mm) 01.07.2011–30.06.2012 (n=149). The mean compression depth during the first period was 47.1mm (SD 11.1) versus 49.6mm (SD 12.0) within the second period (p<0.001). With respect to the corresponding ERC Guidelines 2005 and 2010, the proportion of chest compressions reaching the minimal depth decreased (73.9% vs. 49.1%) (p<0.001). There was no correlation between compression depth and patient age, sex or duration of resuscitation.

Conclusions

The present study was able to show a significant increase in chest compression depth after implementation of the new ERC guidelines. Even by using a real-time feedback system we failed to sustain chest compression quality at the new level as set by ERC guidelines 2010. In consequence, the usefulness of a fixed chest compression depth should be content of further investigations.