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UK — National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

March 27, 2015 Comments off

National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
Source: University of Manchester

We found 18 deaths by suicide per year in in-patients under observation across the UK during 2006-12. We found that half of deaths examined occurred when checks were carried out by less experienced staff or agency staff who were unfamiliar with the patient. A common feature was that staff did not follow the observation plan because the ward was busy or poorly designed. We found that the current observation approach is not working safely enough. New models need to be developed and evaluated.

Federal Practitioner 2015 Directory: VA and DoD Healthcare Facilities

March 18, 2015 Comments off

Federal Practitioner 2015 Directory: VA and DoD Healthcare Facilities
Source: Federal Practitioner

This is a comprehensive directory of DoD and VA health facilities, including a Veterans Integrated Service Network Guide and a Tricare Region Guide. Detailed contact information — including URLs for facility websites — is available, and hospital leadership and department heads are listed by name.

You can print pages from the directory, but you cannot download or print the whole thing as a single document.

free registration required2

2014 Leapfrog Hospital Survey Results Now Available

March 16, 2015 Comments off

2014 Leapfrog Hospital Survey Results Now Available
Source: Leapfrog Group

These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment to transparency by participating in the voluntary Leapfrog Hospital Survey. The survey assesses hospitals on three key areas: how patients fare, resources used in caring for patients, and leadership and structures that promote patient safety. This website also includes information on hospitals’ Hospital Safety Scores.

Changes in Emergency Department Use Among Young Adults After the Patient Protection and Affordable Care Act’s Dependent Coverage Provision

March 12, 2015 Comments off

Changes in Emergency Department Use Among Young Adults After the Patient Protection and Affordable Care Act’s Dependent Coverage Provision (PDF)
Source: Annals of Emergency Medicine

Study objective
Since September 2010, the Patient Protection and Affordable Care Act has allowed young adults to remain as dependents on their parents’ private health plans until age 26 years. This insurance expansion could improve the efficiency of medical care delivery by reducing unnecessary emergency department (ED) use. We evaluated the effect of this provision on ED use among young adults.

Methods
We used a nationally representative ED visit database of more than 17 million visits from 2007 to 2011. Our analysis compared young adults aged 19 to 25 years (the age group targeted by the law) with slightly older adults aged 27 to 29 years (control group), before and after the implementation of the law.

Results
The quarterly ED-visit rate decreased by 1.6 per 1,000 population (95% confidence interval 1.2 to 2.1) among targeted young adults after the implementation of the provision, relative to a comparison group. The decrease was concentrated among women, weekday visits, nonurgent conditions, and conditions that can be treated in other settings. We found no effect among weekend visits or visits due to injuries or urgent conditions. The provision also changed the health insurance composition of ED visits; the fraction of privately insured young adults increased, whereas the fraction of those insured through Medicaid and those uninsured decreased.

Conclusion
The Patient Protection and Affordable Care Act dependent coverage expansion was associated with a statistically significant yet modest decrease in ED use, concentrated in the types of ED visits that were likely to be responsive to changes to insurance status. In response to the law, young adults appeared to have altered their visit pattern to reflect a more efficient use of medical care.

Greener Hospitals: Building Consensus for Health Care Sustainability

March 5, 2015 Comments off

Greener Hospitals: Building Consensus for Health Care Sustainability
Source: Knowledge@Wharton (University of Pennsylvania)

Until recently, health care was not a major part of the sustainability discussion. And the reverse was just as true: Few within the health care industry thought much about sustainability. Yet the two fields overlap in many important ways.

Health care has a sizeable impact on the environment. In her book, Greening Health Care, Kathy Gerwig, vice president of employee safety, health and wellness at Kaiser Permanente, notes that hospitals are the second-most energy-intensive commercial buildings in the U.S. and that the industry is responsible for 8% of the country’s greenhouse gas emissions. “Health care institutions are consistently among the top 10 water users in their communities,” she writes, and they are “the single-largest users of chemical agents.” The volume of waste flowing out of hospitals is mammoth — more than 2.3 million tons per year — including everything from paper and cardboard to infectious materials and radioactive waste.

Emergency Department Visits for Motor Vehicle Traffic Injuries: United States, 2010–2011

February 25, 2015 Comments off

Emergency Department Visits for Motor Vehicle Traffic Injuries: United States, 2010–2011
Source: National Center for Health Statistics

Key findings
Data from the National Hospital Ambulatory Medical Care Survey, 2010–2011

  • In 2010–2011, the emergency department (ED) visit rate for motor vehicle traffic injuries was highest among persons aged 16–24 years. The rates declined with age after 16–24, with rates for those aged 0–15 similar to those 65 and over.
  • The overall ED visit rate for motor vehicle traffic injuries was higher among non-Hispanic black persons compared with non-Hispanic white and Hispanic persons.
  • Imaging services were ordered or provided at 70.2% of ED visits for motor vehicle traffic injuries, which was higher than for other injury-related ED visits (55.9%).
  • About one-half of ED visits for motor vehicle traffic injuries had a primary diagnosis of sprains and strains of the neck and back, contusion with intact skin surface, or spinal disorders.

Utilization of Intensive Care Services, 2011 (December 2014)

February 16, 2015 Comments off

Utilization of Intensive Care Services, 2011
Source: Agency for Healthcare Research and Quality

Highlights

  • In 2011, 26.9 percent of hospital stays in 29 States involved intensive care unit (ICU) charges, accounting for 47.5 percent of aggregate total hospital charges.
  • Common conditions and procedures with high ICU utilization varied across body systems. The highest rate of ICU use (93.3 percent) was for respiratory disease with ventilator support.
  • Cardiac conditions accounted for 8 of the 18 conditions and procedures with high ICU utilization. ICU utilization for cardiac conditions ranged from 40.6 percent for stays for chest pain to 70.3 percent for stays for acute myocardial infarction with major complications or comorbidities.
  • Hospital stays that involved ICU services were 2.5 times more costly than other hospital stays.
  • ICU services were on average three times more likely when patients experienced major complications or comorbidities.
  • Greater utilization of ICUs tended to occur in hospitals that were large, private/for profit, located in metropolitan areas, trained medical students, and had a high-level trauma center.
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