Nearly 20% of patients who are discharged from hospitals return for acute care within 30 days, researchers reported Tuesday. The team, led by Yale emergency medicine researcher Dr. Anita A. Vashi, scoured records collected between July 2008 and September 2009 that reported on 4,028,555 patients in California, Florida and Nebraska. They found that 17.9% of hospitalizations resulted in at least one hospital-based "acute care encounter" within 30 days, including readmissions for inpatient care and emergency department visits. Just over 35% of the trips back to the hospital took place in the first seven days after discharge; 57.4% were in the first 14 days.
While most babies delivered at 38 weeks do not end up in intensive care, research shows they are more likely to have feeding, breathing and developmental problems than those born at 39 or 40 weeks. Since 1979, the American College of Obstetricians and Gynecologists (ACOG) has recommended against deliveries or induced labor before 39 weeks unless there are medical reasons, such as the mother's high blood pressure or diabetes or signs that the fetus may be in distress. Still, an estimated 10 to 15 percent of U.S. babies every year are delivered early without medical cause, according to the Department of Health and Human Services.
Parkland Memorial Hospital has completed 94 percent of the quality and patient safety targets necessary for it to continue receiving federal funding, but the institution continues to struggle in the areas of nurse staffing, timely patient discharges and bedsore prevention, according to a report given to the hospital's Board of Managers Tuesday. Parkland has corrected 469 of 499 problem areas spelled out in a corrective action plan the hospital has been operating under, said Ron Laxton, chief implementation officer and interim chief operating officer for hospital operations. All 499 are supposed to be fixed by April for Parkland to stay eligible to receive about $400 million a year in Medicaid and Medicare reimbursements from the federal government.
Some of the 32 Exeter Hospital patients infected with hepatitis C during the hospital's outbreak last year have cleared the virus from their system, an attorney representing the hospital said. William Dailey Jr., senior partner at Sloane and Walsh in Boston, also said the hospital has been assisting the patients financially with their hepatitis C treatments by taking care of transportation costs, co-pays, medications not covered by insurance, and other expenses.
Doctors are breathing a collective sigh of relief because we again escaped a cut in Medicare payments. But this whole recurrent charade underscores, once again, the unresolved issue of how to pay doctors. The fiscal cliff rescue included the usual "doc fix"—an override of the 27 percent Medicare reimbursement cut required by the Sustainable Growth Rate (SGR) law this year. That law has dictated annual cuts in Medicare reimbursement, which have been overridden by Congress annually. Nevertheless, this escape only postponed the crisis for older patients for another year. Moreover, the budget correction required by overriding the SGR seems to have been largely funded by lowering hospital payments instead—also perhaps bad for patients.
The inspector general at the U.S. Department of Veterans Affairs has initiated a review of practices at the Buffalo VA Medical Center that could have exposed more than 700 patients to HIV, hepatitis B or hepatitis C. The inspector general, George Opfer, confirmed the review in letters to Rep. Brian Higgins, D-Buffalo, and Sen. Charles E. Schumer, D-N.Y., the lawmakers said Tuesday.