The third report since 2004 on how California hospitals treat pneumonia found that patients at the worst- performing hospitals were twice as likely to die as those at the best-ranked hospitals. Los Angeles County is in decent shape, with 20 of 92 hospitals surveyed that rated "better than expected" and four that rated "worse than expected." The report looked at 30-day mortality rates for community- acquired pneumonia between January 2003 and November 2005.
An attorney and an accountant have been charged in an alleged medical insurance scam in which thousands of patients were allegedly recruited to undergo unnecessary procedures at a Buena Park, CA, surgical center in exchange for cash or gifts. The indictment brings to 19 the number of doctors, administrators, recruiters and others charged in the case surrounding the Unity Outpatient Surgery Center, which is now closed. The operation aggressively recruited more than 2,000 patients from around the country to have unneeded procedures, including colonoscopies. In exchange, prosecutors said, the patients were rewarded with cash, vacations and cosmetic surgery, including tummy tucks and face-lifts.
Robin Wittenstein, 48, currently the hospital's chief operating officer, has been tapped to become president and CEO UMDNJ-University Hospital in Newark, NJ. Moody's Investors Services in March warned UMDNJ that its credit rating could be cut, in large part due to operating losses and anticipated state aid cuts to University Hospital. The Moody's report cited a $32 million operating loss for the first six months of the budget year, and "a quick turnaround at the hospital is unlikely," the report said.
Five Palm Beach County, FL, hospitals were cited in 2007 for violating a federal law to prevent patient dumping. Federal records show the hospitals denied about 30 patients emergency specialty care they should have provided. None of the hospitals was fined or lost its Medicare license, the potential consequences of violations. The violations offer a snapshot of how emergency patients get passed among hospitals and highlight a broader crisis in emergency specialty care.
The 2008 state budget for California, in addition to the prospect of even deeper cuts in California's low-income health insurance program, has patients and providers bracing for reduced access to healthcare, including closures of medical facilities throughout the state. Lawmakers already approved one round of Medi-Cal cuts, and they now are weighing more cuts proposed by Gov. Arnold Schwarzenegger. But without a budget currently in place, most doctors, hospitals, pharmacists, and adult day care centers will not be paid for treating the poor, elderly and disabled. Democratic Assembly Speaker Karen Bass, D-Los Angeles, called it an unfortunate situation and said she hoped to strike a budget deal sometime next month before healthcare providers endure more financial hardship.
Democrats assailed Republican senators for voting against a major Medicare bill and said the Republicans should be held responsible for a 10% cut in payments to doctors that takes effect July 1. Doctors, pharmacists and advocates for Medicare beneficiaries said they would step up pressure on members of Congress when they return home for the Fourth of July recess. On June 26, Republican senators blocked efforts by Democrats to take up the bill, which would have stopped the impending cut in payments to doctors.
There were 1,002 cases of serious medical harm disclosed by California hospitals between July 2007 and May of this year, according to disclosures made under a state law that requires hospitals to inform health regulators of all substantial injuries to their patients. State investigators found some errors occurred because hospitals failed to follow safeguards designed specifically to prevent harm.
Increasing use of CT scans, formally known as CT angiograms, is part of a larger trend in American medicine. Faith in innovation, often driven by financial incentives, encourages American doctors and hospitals to adopt new technologies even without proof that they work better than older techniques. The story of the CT angiogram is a reminder of how difficult it is to rein in a new technology long enough to determine whether its benefits are worth its costs.
In the past decade, hip- and knee-replacement surgery has nearly doubled to about 750,000 operations a year and fueled a multibillion-dollar implant industry with profit margins approaching 20%. With so much money in play, competition among artificial hip and knee manufacturers has fostered a system of five-, six- and seven-figure payments to doctors in royalties, consulting deals, and speaking fees. Those financial arrangement have now come under intense scrutiny from federal prosecutors and members of Congress, who are considering legislation requiring disclosure.
Though urgent care centers have existed in small numbers for more than two decades, they're experiencing an explosion in growth now, especially in busy metro areas. Their growth is out-pacing that of retail walk-in medical clinics staffed by registered nurses or physician assistants, which also are expanding rapidly. Urgent care clinics are often dubbed "doc in the box" facilities, and estimates for the number of physician-staffed urgent clinics vary widely. The Chicago-based Urgent Care Association of America, the largest trade group, puts the number at 8,000.
