Health information from The Oklahoman

Stroke guidelines at Baptist

The Integris Cerebrovascular & Stroke Center at Baptist Medical Center is participating in the American Stroke Association’s Get With The Guidelines–Stroke program.

The goal is to improve stroke treatment and prevent future strokes.

The program was developed to help hospitals employ “science-based treatment guidelines,” according to an Integris press release. The guidelines address stroke management and prevention, and the establishment of stroke centers.

“As a GWTG-Stroke participating hospital, Integris Cerebrovascular & Stroke Center at Baptist Medical Center is encouraged to develop a comprehensive system for providing rapid diagnosis and treatment of stroke when patients are admitted to the emergency department. This includes always being equipped to provide brain-imaging scans, making neurologists available to conduct patient evaluations and using clot-busing medications when appropriate,” according to the release.

Treatment and prevention of strokes includes use of statins and anti-platelet medications, treatment of atrial fibrillation and atherosclerosis, and management of weight, diabetes and cholesterol.

Through the GWTG-Stroke program, the American Stroke Association provides Baptist with training and staff recommendations, “care maps,” discharge protocols, standing orders, and data collection and measurement tools.

According to the stroke association, approximately 700,000 people suffer a stroke each year.

 For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

Hospital tally approaches $1 trillion

U.S. hospitals charged $873 billion in 2005 — a nearly 90 percent increase from the $462 billion charged in 1997 — according to the Agency for Healthcare Research and Quality. The inflation-adjusted 2005 bill represents the amount charged for 39 million hospital stays.

With an average annual growth rate in hospital charges of 4.5 percent, researchers predict the bill will reach $1 trillion by 2008.

AHRQ also found:

-Medicare paid $411 billion of the national bill, followed by private insurance ($272 billion) and Medicaid ($124 billion). 

-The uninsured accounted for $38 billion. 

This is taken from the AHRQ report:

For more health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.  

Jeff Raymond, Medical Writer

Elderly visitors may overwhelm emergency rooms

Rates of visits by the elderly to emergency rooms are outpacing those of other groups, which could lead to “catastrophic overcrowding,” according to a study this week in the Annals of Emergency Medicine.

“Seniors are using the emergency department more and more frequently, and given the needs of this population and the nature of their medical problems, the current state of overcrowding is likely to continue to escalate dramatically,” Dr. Mary Pat McKay of The George Washington University Medical Center said in a press release.  “These patients tend to be sicker and are more likely to be admitted from the emergency department to the hospital, but with many hospitals running a deficit of inpatient beds, I don’t see where these patients are going to go.”

Researchers studied ER visits from 1993 to 2003, and found that visits per 100 people 65 and older increased faster than the visit rate for any other age group, with an overall increase of 26 percent during the study period.

“People aged 65 and older are the fastest growing segment of the U.S. population. As emergency patients, they use the most resources, stay the longest, and are the most likely to be admitted to the hospital of all emergency patients.  Researchers conclude that emergency department visits in the United States for patients between 65 and 74 could nearly double from 6.4 million in 2003 to 11.7 million by 2013,” according to the release.

AARP Policy Director John Rother called on elected officials to “heed the warnings” of the report and recognize that the health care system must deliver appropriate, affordable care.

 “The trends released today underscore the need to make sure emergency departments can meet the demand for care by older people, but we also need a better understanding of why emergency room use by older people is on the rise and why these patients may not be getting care from their personal physicians,” he said in the release.

The study suggests older Americans are having more genuine emergencies, rather than increasingly visiting the emergency department.

For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

Last Integris drive-through flu clinic

Integris Pacer Fitness Center is offering its last drive-through flu clinic of the season.

Just drive up, roll down the window, roll up your sleeve and get vaccinated.

The clinic will be from 9 a.m. to 1 p.m. Saturday in the Integris Baptist Medical Center East Parking Lot.

The cost per flu shot is $22. A pneumonia shot is $30. Medicare will not be accepted.

 Jeff Raymond, Medical Writer

ER payments decrease

Emergency room payments declined over an 8-year period, with Medicaid paying less overall than do uninsured patients, a recent study in the Annals of Emergency Medicine reported.

In a news release, researcher Dr. Renee Hsia of the University of California at San Francisco said the “falling reimbursements” were a “consistent trend” over the study period.

“What surprised us was that uninsured patients actually pay a higher proportion of their emergency department charges than Medicaid does,” she said.

According to the release, 35 percent of charges for uninsured visits were paid in 2004, compared to 33 percent for Medicaid visits.

Researchers studied charges and payments for 43,128 emergency department visits from 1996-2004. Nationally, the overall proportion of charges paid for outpatient emergency room visits declined from 57 percent to 42 percent.

“Declining reimbursement ratios will cut into the ability of emergency departments to recover their actual costs of providing care,” Hsia said.

Jeff Raymond, Medical Writer

Reducing hospital-acquired infections

Consumers Union, publisher of “Consumer Reports,” has made reducing nosocomial, or hospital-acquired, infections a major focus. To learn more, visit www.consumersunion.org/campaigns/stophospitalinfections/learn.html.

Researchers and others track hospital-acquired infections, but the information often isn’t publicly available or disseminated. Some states track the rate; Oklahoma doesn’t.

This is too bad, because nosocomial infections, especially the drug-resistant variety, are a huge health care problem and deserve scrutiny from the media and patients.

I would like to hear your experience with hospital-acquired infections. Have you or a loved one contracted an infection while hospitalized or shortly after discharge? Do you think hospitals and doctors do enough to reduce infections or pay enough attention to the risk? Would greater disclosure of hospital infection rates be something you would research?

Health care providers: How do you deal with nosocomial infections? Are your efforts enough? Are hospitals unfairly criticized? Can infection rates be reduced enough to matter?

The November issue of “Clinical and Infectious Diseases” documents a 7 percent annual increase from 1998 to 2003 in the rate of nosocomial Staphylococcus aureus infections.

The largest increase was among patients hospitalized for invasive orthopedic procedures — 53.5 percent.

The economic impact of hospital-acquired infections is more than $10 billion.

 If you’d like to talk about this, please e-mail me at jraymond@oklahoman.com or call 475-3364.

Jeff Raymond, Medical Writer

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