Doctors sometimes call the anesthesia drug by its nickname—milk of amnesia. Patients are calling it the "Michael Jackson drug." Ever since propofol was blamed in the singer's death, patients who seldom asked or cared about what kind of sedation they were getting were suddenly peppering their doctors with questions about the potent drug. "You won't believe how many people with their eyes wide open ask me: 'Are you going to give me the Michael Jackson drug?' They're scared to death," said H.A. Tillmann Hein, MD, president of the Texas Society of Anesthesiologists. While some initially balk at going under, fearing they will end up like Jackson, they come around after Hein explains that propofol, widely used for surgeries and other procedures for more than 20 years, is safe when used by a trained professional in a hospital or clinic. Propofol gained notoriety in 2009 after an autopsy found Jackson died of an overdose. Prosecutors have accused his personal physician, Conrad Murray, MD, of giving the 50-year-old pop icon a lethal dose at the singer's rented Los Angeles mansion.
Hospitals across Georgia and the nation are increasingly working with home healthcare providers, nursing homes and family doctors to better coordinate care beyond their walls to ensure discharged patients don't end up back through their doors just days or weeks later. While key to improving the quality of care, failing to reduce readmissions could soon put hospitals at risk of losing millions of federal dollars. Avoidable readmissions of patients within 30 days cost Medicare more than $17 billion each year -- burdening an already taxed healthcare system. Many readmissions -- which can cost between $6,000 and $10,000 each -- reflect inadequate discharge planning and poor follow-up care, industry observers say. Starting next year, Medicare -- the federal health program for people 65 and older -- plans to stem costs by cutting payments to hospitals with excessively high readmission rates.
Hospital stays for heart failure fell a remarkable 30% in Medicare patients over a decade, the first such decline in the United States and forceful evidence that the nation is making headway in reducing the billion-dollar burden of a common condition. But the study of 55 million patients, the largest ever on heart failure trends, found only a slight decline in deaths within a year of leaving the hospital, and progress lagged for black men. "While heart failure hospitalizations have decreased nationally overall, certain populations haven't seen the full benefit of that decrease," said lead author Dr. Jersey Chen of Yale University School of Medicine. Possible explanations for the decline in hospital stays abound, including healthier hearts, better control of risk factors like high blood pressure, and more patients treated in emergency rooms and clinics without being admitted to hospitals, said Dr. Mariell Jessup, medical director of the Penn Heart and Vascular Center in Philadelphia.
Whether or not trauma centers meet national safety standards says little about a patient's risk of dying or getting an infection while there, according to new research. The findings add to evidence that quality measures meant to improve hospital outcomes may not be as effective as hoped. Earlier this month, for instance, another study found that hospitals scoring high for their treatment of children with asthma aren't better at preventing those kids from ending up in the emergency room with asthma attacks (see Reuters Health story of October 4, 2011). The latest results, published in the Archives of Surgery, show that hospital scores on the so-called Leapfrog Safe Practices Survey weren't linked to either death rates or hospital-associated infections. The survey asks hospitals about how they staff their intensive care unit, among other things, and how they try to avoid blood stream infections from catheters.
The U.S. healthcare system is lagging further and further behind other industrialized countries on major measures of quality, efficiency and access to care, according to a new report from the nonprofit Commonwealth Fund, a leading health policy foundation. That is having a profound effect on overall health in the U.S., the report found. Americans die far more frequently than their counterparts in other countries as a result of preventable or treatable conditions, such as bacterial infections, screenable cancers, diabetes and complications from surgery. In 2006-07, the U.S. recorded 96 preventable deaths per 100,000 people. By comparison, France, with the best performing healthcare system, recorded just 55 deaths per 100,000.
New guidelines for diagnosing and treating attention deficit hyperactivity disorder could lead pediatricians to diagnose the condition in kids as young as four and to continue treating teens through high school on stimulant drugs like Ritalin and Adderall. The recommendations, released Monday at the American Academy of Pediatrics annual meeting in Boston, state that primary care physicians should do a diagnostic workup and initiate treatment for ADHD for any child aged 4 through 18 who has academic or behavioral problems and has trouble with inattention, hyperactivity, or impulsivity. The previous guidelines issued a decade ago only applied to children aged 6 through 12 since at that time, there a was a lack of research in preschoolers and teens, according to Dr. Mark Wolraich, chair of the guideline committee.