The North Carolina Department of Correction is readying a new medical complex at Central Prison to replace buildings that are too cramped and outdated to adequately treat a growing and aging prison population. The new $155 million hospital and mental health facility just west of downtown will begin accepting patients next month. Demolition of the old hospital starts Nov. 28. Corrections officials say the expanded medical treatment offered in the facility will cut the cost of treatment in outside hospitals by a third. And the expansion comes at a time when community hospitals are pushing the prison system to take care of more of its own patients.Security also was a factor, as prisoners require constant supervision during the hospital visits.
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.
Starting four years ago, the Cleveland Clinic stopped hiring smokers, launched a healthy-food initiative and removed sugared beverages from its campuses. The Clinic's Chief Executive Dr. Toby Cosgrove endured national criticism as a health zealot and fast-food hater who was over-stepping his bounds as an employer. Now, Cosgrove and the Clinic's 41,000 employees are enjoying the results: Healthcare costs are flattening. "We changed the environment so it's easy to stay healthy; It's hard to get unhealthy," said Dr. Michael Roizen, the Clinic's Chief Wellness Officer and national guru on all things healthy. Across the country the average health insurance premium for family coverage rose 9% this year. At the Clinic, some employees haven't paid a premium increase in two years.
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.