Florida is facing an explosion in its number of elderly Hispanic residents, raising concerns about the strain on a healthcare system that is not prepared to handle their unique needs. In 1995, U.S. census officials said Florida would face a 102% increase in Hispanics age 65 and older by 2010. By 2007, the Hispanic elderly population had already increased by 124% to 530,000 people, or 12.5% of the senior population. Nurses and doctors who speak Spanish are sorely needed, but the language barrier isn't the only concern. Sometimes there are cultural differences that can affect a patient's care, experts say.
In this blog entry from the New York Times, Georgia based physician Robert Lamberts, MD, offers a few simple rules he follows to help him get along better with his patients. Blogger Tara Parker-Pope says hundreds of readers have commented about how frustrated they are with doctors and the medical system, and these rules may help.
Two things that we know: One, that sick people turning up in emergency rooms is the least cost-effective way to treat them, and two, that most of the costs in healthcare are tied up in treating the chronically ill. But knowing what the problem is and solving it are two different things, as new reports this week demonstrate.
A report by the Centers for Disease Control and Prevention found that Americans made 119 million emergency room visits in 2006, and increase of 32% in a decade. Perhaps even more disturbing was the study's conclusion that patients with Medicaid use emergency services at a rate of 82 per 100 persons, compared to 21 per 100 for those with private insurance. Of all hospital impatient admissions, nearly half come through the ED, up from 36% a decade ago.
The report certainly suggests that despite many well-meaning initiatives to encourage people to make better use of physician offices, clinics, and other primary providers, patients still are choosing—since the numbers arriving by ambulance remained relatively stable—to take the most intensive route possible.
Maybe "choosing" is not the correct word. A convergence of more uninsured, shrinking availability of primary care physicians, and the declining willingness of those physicians to take government reimbursement at reduced rates is forcing people to the wrong healthcare door. So what to try next? Raise copays into the thousands? Boost primary care strength at a financial loss? The solutions don't get any more appealing. Another study, this one from the Annals of Internal Medicine, found that as many as one in three uninsured—an estimated 16 million—have a chronic condition for which they either receive no treatment or show up in emergency rooms for their care. True numbers of how many uninsured have a condition like high blood pressure or diabetes are difficult to estimate since many have not touched the healthcare system.
These two studies are not so much new information as they are an invoice—a little reminder that the bill is due and that the interest rate will hurt. Managing inflow to the ED may well require some more aggressive policies no one really wants, and the costs for truly treating all those chronically ill uninsured are really going to hit hard with any discussion of universal coverage.
Jim Molpus is Editor-in-Chief of HealthLeaders Media. He can be reached at jmolpus@healthleadersmedia.com.
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South Florida Roman Catholic hospitals Holy Cross and Mercy will combine operations under a joint chief executive, the hospitals have announced. John C. Johnson, the top boss at Fort Lauderdale-based Holy Cross Hospital, has been selected to head a new Catholic Health East organization in Southeast Florida that will include Holy Cross and Mercy Hospital in Miami. In his new role, Johnson will be responsible for overall strategic planning and operating performance for the two hospitals.
Orlando, FL, hospitals see labor and delivery as big business and are competing to make their rooms feel less like an infirmary and more like a resort. Two years ago, Orlando Health's Winnie Palmer Hospital for Women & Babies opened a $112 million ultra-contemporary tower that intensified the local chase to attract expectant mothers. Now Florida Hospital, operated by Adventist Health System, feels pressure to step up its game. Florida Hospital invested more than $16 million last year to refurbish its maternity unit in Winter Park and another $4 million at its Orlando hospital by October. By next year, Florida Hospital Orlando's pediatric unit will be the first hospital to bear the Disney name thanks to a $10 million donation from Walt Disney World.
Kaiser Permanente announced it's moving ahead with a fifth year of its ubiquitous Thrive advertising campaign, a multi-media effort with an annual budget this year of $50 million. The latest incarnation will debut during coverage of the 2008 Summer Olympics opening ceremony in Beijing, China. Other new ads will launch next month, and the latest Thrive effort will focus more on the Internet and other "non-traditional" venues than in prior years. The television, radio, print and outdoor advertisements focus on topics such as prevention, wellness, and "thriving" at every stage of life, according to Kaiser.