XSTAT, an innovative sponge-filled dressing device recently saved a life

From Gizmodo:

In this first reported case, a soldier suffered a gunshot wound to the left thigh. After seven hours of unsuccessful surgery to stop the bleeding, the doctors decided to use XSTAT. Here’s a detailed description from the Journal of Emergency Medical Services:

The femoral artery and vein were transected and damage to the femur and soft tissue left a sizable cavity in the leg. After a self-applied tourniquet stopped the bleeding, the patient was transferred to an FST for evaluation and treatment. After proximal and distal control of the vessel was achieved, several hours were spent by the team trying to control residual bleeding from the bone and accessory vessels. Throughout the course of the roughly 7-hour surgery, multiple attempts at using bone wax and cautery on the bleeding sites were unsuccessfull and the patient received multiple units of blood and plasma. Eventually, the FST team opted to use XSTAT and applied a single XSTAT device to the femoral cavity— resulting in nearly immediate hemostasis. The patient was stabilized and eventually transported to a definitive care facility.

Primary Care Doctor Pay Surpasses $250K Annually

From Forbes:

Compensation of primary care physicians has eclipsed $250,000 a year as doctors are increasingly paid via value-based care models that emphasize quality, better outcomes and keeping their patients healthy.

The new Medical Group Management Association annual compensation survey shows median primary care doctor compensation rose 4.3 percent to $251,578 in 2015 from a year earlier as the role gains importance in the U.S.health system. Primary care doctors in the survey of 80,000 providers include internists, family physicians and pediatricians that are among the most in-demand health professionals.

Total health care costs for typical family will top $25,000 this year

From the Journal-Sentinel:

The average total cost of health care for the typical family of four will top $25,000 this year.

That projection — from the annual Milliman Medical Index — includes the average cost of health insurance paid by employers and employees, as well as deductibles and out-of-pocket expenses for the most common type of health plan.

The total cost — $25,826 this year — may prompt disbelief. But few people realize what their employer spends to provide health benefits or the potential cost of deductibles and other out-of-pocket expenses if someone in a family has a serious illness or even a series of relatively minor mishaps.

“A lot of people are sheltered from the true cost of health care, despite the fact that they are paying more than in the past,” said Scott Weltz, a principal and consulting actuary who works out of Milliman’s office in Brookfield.

They are paying much more: The Milliman Medical Index has more than tripled since its first year in 2001.

Emergency Physician Takes ED Logbook Home. Stolen From Her Car.

From Tucson:

A Tucson doctor’s logbook was stolen from her car in March, compromising protected health information for more than 1,000 patients who visited Carondelet St. Mary’s and Carondelet St. Joseph’s emergency rooms.

All patients have been notified of the breach of confidentiality and have been offered a year of free credit monitoring, said Dr. Lori Levine, privacy officer for Emergency Medicine Associates, which provides ER staffing coverage for the two hospitals’ emergency departments.

The logbook covered patient visits between Oct. 14, 2015, and March 25, and contained the following patient details: name, date of birth, age and gender, hospital name, date of hospital visit, hospital medical record number, a hospital number identifying the visit, and in some cases, a short description of the patient’s medical issue.

Factors associated with emergency department visit within 30 days after discharge.

From PubMed:

BACKGROUND:

Post-discharge care remains a challenge because continuity of care is often interrupted and adverse events frequently occur. Previous studies have focused on early readmission but few have investigated emergency department (ED) visit after discharge.

METHODS:

This retrospective observational study was conducted between April 2011 and March 2012 in a referral center in Taiwan. Patients discharged from the general medical wards during the study period were analyzed and their characteristics, hospital course, and associated factors were collected. An ED visit within 30 days of discharge was the primary outcome while readmission or death at home were secondary outcomes.

RESULTS:

There were 799 discharged patients analyzed, including 96 (12 %) with an ED visit of 12.4 days post-discharge and 111 (14 %) with readmissions at 13.3 days post-discharge. Sixty patients were admitted after their ED visit. Underlying chronic illnesses were associated with 72 % of ED visits. By multivariate analysis, Charlson score and the use of naso-gastric tube were independent risk factors for ED visit within 30 days after discharge.

CONCLUSIONS:

Early ED visit after discharge is as high as 12 %. Patients with chronic illness and those requiring a naso-gastric tube or external biliary drain are at high risk for post-discharge ED visit.

Innovative program reducing frequent ER use

From the News-Press:

A pilot program designed to prevent people from repeatedly using Lee County’s swamped hospital ERs, particularly for non-life-threatening substance abuse and mental health disorders, has successfully reduced usage, a new report finds.

The Extended Community Health Outreach, or ECHO, program gives patients who frequently use ERs help finding housing, access to mental health or substance abuse treatment, and information to better maintain their chronic illnesses, such as diabetes.

Since it began with a handful of patients in 2013, ECHO has resulted in nearly 500 fewer ER visits by these patients and an estimated $320,000 in avoided treatment costs, according to Lee Memorial Health System.

Should hospitals pay property taxes?

From the Daily Herald:

The case of whether a downstate hospital can be exempt from property taxes could have a multimillion dollar impact on suburban hospitals and governments in a dispute that’s been going on for years.

The Illinois Supreme Court this week agreed to hear arguments over a 2012 state law that allows hospitals to apply to be exempt from property taxes if they provide a certain amount of free care or subsidies to individual patients or governments.

The problem for the hospitals: An appellate court ruled this year the law is unconstitutional. After all, the court argued, not all the services provided in a hospital are for charity.