Health and Medical News and Resources

General interest items edited by Janice Flahiff

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits

drugs redux

drugs redux (Photo credit: Phoenix Dark-Knight)

 

Summary of the paper from Full Text Reports

 

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits (PDF)
Source: Substance Abuse and Mental Health Services Administration

This publication presents national estimates of drug – related visits to hospital emergency departments (EDs) for the calendar year 2011 , based on data from the Drug Abuse Warning Network (DAWN). Also presented are comparisons of 20 11 estimates with those for 2004, 200 9, and 2010 . DAWN is a public health surveillance system that monitors drug – related ED visits for the Nation and for selected metropolitan areas. The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), is the agency responsible for DAWN. SAMHSA is required to collect data on drug – related ED visits under S ection 505 of the Public Health Service Act.

DAWN relies on a nationally representative sample of general, non – Federal hospitals operating 24 – hour EDs , with oversampling of hospitals in selected metropolitan areas. In each participating hospital, ED medical records are reviewed retrospectively to find the ED visits that involved recent drug use. All types of drugs — illegal drugs, prescription drugs, over – the – counter pharmaceuticals (e.g., dietary supplements, cough medicine), and substances inhaled for their psychoact ive effects — are included. Alcohol is considered an illicit drug when consumed by patients aged 20 or younger. For patients aged 21 or older, though, alcohol is reported only when it is used in conjunction with other drugs.

Marked findings of this report a re (a) a 29 percent increase in the number of drug – related ED visits involving illicit drugs in the short term between 2009 and 2011 ; (b) simultaneous, short – term increases in the involvement of b oth illicit and licit stimulant – like drugs ; and (c) some ind ications that the pace of increases in pharmaceutical involvement is slowing down.

 

 

July 19, 2013 Posted by | health care | , , , , , , , , | Leave a comment

American Red Cross App Puts Emergency Care Instruction in the Palm of Your Hand

Flag of the Red Cross

Image via Wikipedia

Red Cross Teams Up with Dr. Oz and Sharecare to Launch Lifesaving App

From the American Red Cross Web page

 

WASHINGTON, Wednesday, June 01, 2011 — Just in time for the busy summer season, a new smartphone app launched today by the American Red Cross, Dr. Mehmet Oz and the medical website Sharecare makes it even easier for the average person to help in an emergency.

The “S.O.S by the American Red Cross” is a free app that provides real-time emergency care instructions and an expansive resource guide for emergency care information in order to help save lives. The app is available only for Android mobile devices.

Once activated, app users are guided through a victim assessment and receive step-by-step video narration and follow-along demonstrations by Dr. Oz. More than 30 protocols for the most common emergency care situations were adapted for the Android app. 3-D animations, provided by Visible Productions, Inc., are included for the more complex protocols, specifically Hands-Only CPR and Choking along with an audio and visual counter for real-time CPR compressions.

The Resource Guide covers more than 50 common emergency care situations with easy to understand instructions for treating seizures to broken bones….

 

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In addition to the emergency protocols and resource guide, the S.O.S. app features 9-1-1 dialing that auto-launches a map with location information, while on the call with the emergency dispatcher.

To get the app, Android users can go to https://market.android.com and download the “S.O.S by the American Red Cross” app for free. Contact your local Red Cross or visit redcross.org for information on Red Cross training offerings. For additional life-saving and healthcare information, visitsharecare.com.

June 11, 2011 Posted by | Consumer Health, Public Health | , , | 1 Comment

Trauma patients protected from worse outcomes associated with so-called ‘weekend effect’

Emergency room after the treatement of a trauma

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Trauma patients protected from worse outcomes associated with so-called ‘weekend effect’

From a March 21 2011 Science Daily news article

ScienceDaily (Mar. 21, 2011) — Patients who’ve been hurt in car or bike crashes, been shot or stabbed, or suffered other injuries are more likely to live if they arrive at the hospital on the weekend than during the week, according to new University of Pennsylvania School of Medicine research published in the March 21 issue of Archives of Surgery. The findings, which also showed that trauma patients who present to the hospital on weeknights are no more likely to die than those who presented during the day, contrast with previous studies showing a so-called “weekend effect” in which patients with emergent illnesses such as heart attacks and strokes fare worse when they’re hospitalized at night or on weekends.

The authors say the trauma system’s unique organization and staffing appears to serve as a built-in protection for these critically injured patients, and may provide a roadmap for ongoing efforts to restructure and better coordinate U.S. emergency care, which needs to provide optimal care day or night.

“Whether patients have an emergent illness or a severe injury, the common denominator is time. Patients must rely on the system to quickly get them to the place that’s best prepared to save their lives,” says lead author Brendan G. Carr, MD, MS, an assistant professor in the departments of Emergency Medicine and Biostatistics and Epidemiology. “Trauma systems have been designed to maximize rapid access to trauma care, and our results show that the system also offers special protection for patients injured during periods that are known to be connected to worse outcomes among patients with time-sensitive illnesses.”…

March 22, 2011 Posted by | Public Health | , , , | Leave a comment

Health care spending: Study shows high imaging costs for defensive purposes

Health care spending: Study shows high imaging costs for defensive purposes
Costs and frequency of defensive medicine in Pennsylvania

AAOS: American Academy of Orthopaedic Surgeons® / American Association of Orthopaedic Surgeons®

From the February 16, 2011 Eureka news alert

Nearly 35 percent of all the imaging costs ordered for 2,068 orthopaedic patient encounters in Pennsylvania were ordered for defensive purposes, according to a new study presented today at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

For many years now, some physicians have ordered specific diagnostic procedures that are of little or no benefit to a patient, largely to protect themselves from a lawsuit. Until now, however, efforts to actually measure defensive medicine practices have been limited primarily to surveys sent to physicians. Such surveys would simply ask whether or not that individual actually practiced defensive medicine.

“This is the first study we know of that looked at the actual practice decisions of physicians regarding defensive imaging in real time — prospectively done,” says John Flynn, MD.

Flynn, who is Associate Chief of Orthopaedic Surgery at Children’s Hospital of Philadelphia, says that many lawsuits hinge on the plaintiff’s lawyer’s claim that the doctor should have ordered extra diagnostic testing. “And such a claim may be the driving force of so much of the defensive test ordering.”

According to Flynn, 72 orthopaedic surgeons, who are members of the Pennsylvania Orthopaedic Society, voluntarily participated in this study, which included some 2,068 patient encounters throughout the state of Pennsylvania. Most patients in this study were adults. The study found that 19 percent of the imaging tests ordered were for defensive purposes. Defensive imaging was responsible for $113,369 of $325,309 (34.8 percent) of total imaging charges for this patient cohort, based on Medicare dollars. The overall cost of these tests was 35 percent of all imaging ordered because the most common test was an MRI, an imaging test which costs more than a regular X-ray.

One piece of this problem to remember, Flynn says, is that the legal environment that drives physicians to order additional tests has an effect on patients too, in a way that involves more than costs. “Patients are sometimes put through tests that maybe otherwise would not be ordered.”

The finding from this research that surprised Flynn the most was that surgeons were more likely to practice defensively if they had been in practice for more than 15 years.

“This was counterintuitive,” he says. “I thought that young doctors would come out of medical school immediately after training, be less confident because they weren’t experienced, and order more defensive tests. Then, as they become more comfortable and confident after 10 or 20 years in practice, they would order many fewer tests.”

“In fact, the opposite was true. We found that — in Pennsylvania at least — a surgeon’s defensive nature gets worse over time. In this legal environment, orthopaedic surgeons order more imaging tests of a defensive nature, because over time they become more concerned that someone is going to second guess or sue them.”

Flynn says that medical liability awards typically are given because of the severity of a bad outcome, and not necessarily because of negligence. In fact, a May 2006 study published in the New England Journal of Medicine (Studdert DM) showed that 37 percent of claims did not involve medical errors, and in 3 percent of claims, no injury occurred at all.

Flynn pointed to various studies that show that defensive medicine, in general, is quite prevalent. One such study in the June 2005 Journal of the American Medical Association (Studdert DM) reported that almost 93 percent of 824 physicians in Pennsylvania responding to a survey practiced defensive medicine.

“Ideally, as a next step, we would hope to try to get a broader national picture using this prospective practice audit methodology, so we could get a better sense of the true costs of defensive imaging in orthopaedics,” says Flynn.

“Ultimately, if you had doctors from multiple specialties — from OB/Gyn to Neurosurgery to Emergency Medicine — do this type of practice audit, you could accurately quantify how much of our nation’s healthcare resources are wasted on defensive medicine.”

 

 

 

 

February 16, 2011 Posted by | Medical and Health Research News | , , , , , | Leave a comment

   

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