Docs call for proactive use of Narcan

From the Herald:

Suspected opioid overdoses among young children should be treated more often with the life-saving reversal agent Narcan, and prevented with a cap on doses for potentially deadly prescriptions, local doctors are urging.

“Certainly in the era that we are currently in, in terms of prevalence of prescriptions of illicit opioids in the state of Massachusetts, I think opioid intoxication should be on the list of potential diagnoses for pediatric patients,” said Dr. Lauren Allister, pediatric emergency doctor at Massachusetts General Hospital.

“And given potential lethal effects of an opioid overdose,” she added, “the benefits of giving Narcan greatly outweigh the risks of missing an opioid intoxication.”

 

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Rural hospitals keep closing. What can be done?

From Healthcare Dive:

Since 2010, 71 hospitals have closed, fueled by congressional spending measures that cut Medicare payments and by the ACA, which favors hospitals that do a high-volume of business. One of the latest closings came this month in Ellington, MO. The pace is escalating: Last year, the rate of closures was six times greater than in 2010.

According to the National Rural Health Association, another 683 rural hospitals are at risk of closing — taking with them, should that occur, 700,000 patient encounters, 36,000 healthcare jobs, 50,000 community jobs and $10.6 billion in U.S. revenues. Overall, 35% of rural hospitals operate at a financial loss.

Cuts in reimbursement for bad debt have been particularly hard on rural hospitals, which often operate at the narrowest of margins, said Maggie Elehwany, vice president of government relations at the NRHA. Not only do rural hospitals experience lower volume of patients than their urban counterparts, their patients tend to be older, poorer, and sicker. Elehwany said it’s probably not coincidental that most of the closures have occurred in states that have not expanded their Medicaid programs.