A child gets rushed into an emergency room and doctors order a CT scan ? one of the most reliable diagnostic tools to check for maladies from appendicitis to traumatic injuries. But computed tomography imaging, the technology that took away the guesswork, has caused another medical puzzle. Doctors increasingly order the tests but don't really know how many of the procedures expose a child to enough radiation to cause cancer. Dr. David Gaw, a Nashville orthopedic surgeon, worries that doctors are needlessly exposing children to radiation by ordering CT scans too quickly and too often.
More than four years ago, the Wisconsin Collaborative for Healthcare Quality set out to compare its information on healthcare quality with Medicare claims data. The group was one of six nationwide chosen for the research project. "We thought it would be extraordinarily easy," said Amy Topel, who managed the project. "And it didn't turn on out to be." The same discovery could await similar groups in coming years. Last week, the Department of Health and Human Services said it will make its database on Medicare claims available to groups that track health care quality and cost.
Harlan Ginsberg of Coral Springs was rushed to Margate's Northwest Medical Center in 2006 after a kidney stone attack. During surgery to remove the stone, he says, a doctor mistakenly cut a tube that delivered urine to his bladder and removed a kidney that another doctor testified was healthy. Relying on a voter-approved provision in Florida's Constitution, Ginsberg's medical malpractice attorney asked Northwest Medical to turn over its reports about other patients' "adverse medical incidents" of the type Ginsberg claimed he suffered. The hospital initially refused. Later, it agreed to search its records ? but only if Ginsberg coughed up $77,550 in advance.
For more evidence that the Golden State has lost some of its luster, consider this news from the federal government: California spends less per person on healthcare than all but eight states. New data show that total spending by insurers, government agencies and individuals amounted to $6,238 per resident in 2009, well below the national average of $6,815. That puts California on a bottom tier with Arkansas, Georgia, Texas, Utah, Nevada, Arizona, Colorado and Idaho. Healthcare analysts blame the low spending largely on the fact that the state has more than 7 million people who are uninsured, or about 1 in 5 Californians. As a result, many of these people seek medical treatment only when they are severely ill or injured.
Twelve years ago, when the University of Kansas Hospital looked at its quarterly patient satisfaction surveys, it often found ratings in the single digits. Today, when it looks at weekly reports, it takes notice if a department's ratings slip below 90 percent. And if a unit's ratings fall below 80 percent, a customer service SWAT team is summoned. Starting with about 4,000 existing employees at the outset, the hospital has mandated a daylong service session as part of every new hire's three-day orientation.
Parents can sometimes be clueless about the fact that their kids are too heavy, but doctors may not be steering them in the right direction. A study finds that less than a fourth of parents recollect their healthcare providers telling them their children were overweight. From 1999 to 2008, 4,985 parents of children age 2 to 15 who had a body mass index in the 85th percentile or higher were asked if they had ever been told by a physician or health professional that their child was overweight. Overall, 22.4% of parents reported they'd been told. Percentages tended to be higher among minorities, older children, poorer children and those who had public insurance and logged more healthcare visits.