Category: Health Care Reform

Bad Hearts, Bad Healthcare, or Both in Eastern Kentucky?

ptca-2010

Counting Angioplasties:
Too many, too few, or just right?
Although it is St. Joseph London Hospital that is taking the heat in Kentucky over accusations of performing medically unnecessary cardiac catheterizations and other invasive cardiac procedures, it is certainly not alone nationally in this regard. I examined publicly available health data from the Kentucky Hospital Association (KHA) website which confirmed that St. Joseph London was performing a lot of cardiac catheterizations and other invasive cardiac procedures for such a small hospital in a rural part of our state. The hospital today claims to perform over 3000 heart catheterizations a year, although not all are angioplasties.  Of course, absolute numbers alone do not indicate that anything improper occurred, However, given the nature of the accusations, the precedents elsewhere, and in the best interests of both the hospital and the patients it serves; it is my belief that a careful and transparent review is in order. [Addendum:  We can now be sure that very much that was improper occurred!] Continue reading “Bad Hearts, Bad Healthcare, or Both in Eastern Kentucky?”

New Leapfrog Hospital Safety Scores: Better, Worse, and the Same.

leapfrog-map-nov2012-croppedIn June 2012, the Leapfrog group released the first iteration of its Hospital Safety Scores. Drawing heavily on information collected by the federal government for the Medicare program, and supplemented by additional information submitted by hospitals voluntarily to the Leapfrog Hospital Survey, the Safety Scores attempt to highlight aspects of hospital operations that are indicative of safety as contrasted to elements relating to quality. Obviously a distinction between safety and quality is very fuzzy indeed, but it is my impression that the Safety Scores attempt to focus on preventable occurrences in hospital that cause harm. The information underlying the Safety Scores represent a combination of procedures in place for prevention as well as a count of selected actual adverse events. In November 2012, an updated set of Hospital Safety Scores was released. Continue reading “New Leapfrog Hospital Safety Scores: Better, Worse, and the Same.”

New Epidemic of Meningitis: Predictable and Unnecessary.

National news media of all sorts have been reporting about an “epidemic of meningitis” associated with contaminated steroid shots given for back pain. I might as well chime in too. There have been 47 cases identified so far with five deaths, including one Kentuckian. Because hundreds or even thousands of people have received such injections, these numbers will surely increase over the next few weeks. Meningitis is inflammation or infection of the tissues surrounding the spinal cord and brain. The epidural or peri-spinal steroid shots in these cases are injected deeply around the spine and close (if not adjacent) to the meninges. Once the infection breaks through into the spinal fluid or bloodstream, it spreads widely in short order including to the brain. Continue reading “New Epidemic of Meningitis: Predictable and Unnecessary.”

Cure and Outrage Coexist Comfortably in American Medicine

The medicine that we are too willing to swallow.

It has only been a lack of time, never of material, that limits the number of entries in this column. (Are any of you out there interested in writing about something?) One has only to open the local newspaper or watch any news program to stumble across things that should cause our ears to perk up, if not make our blood boil. Last Friday’s Courier-Journal provides a typical example. There were no fewer than five different news articles that were exactly on point for issues we have been writing about this past year. The articles highlighted the massive squandering of money and flesh by a broken healthcare system, a substantial risk of the most commonly touted screening procedure, an example of the unconscionable bills that hospitals are willing to present to their patients, a Kentucky hospital being sued for massive but lucrative overtreatment, and a report of still one more widely used treatment for Alzheimer’s syndrome that didn’t work. There seems to be no limit to the amount of abuse the American public is willing to take from the healthcare industry that is supposed to serve them. Fortunately for me, I don’t have much hair to pull out anymore. Continue reading “Cure and Outrage Coexist Comfortably in American Medicine”