Major Increase In Hospitalization Rates For Children With Psychiatric Disorders

From the 12 August 2011 Health News Today article

Short-stay inpatient hospitalizations for children and adolescents with a psychiatric diagnosis increased significantly over a 12-year period (1996 to 2007) and decreased for the elderly, according to a report in the early online edition in Archives of General Psychiatry by Joseph C. Blader, Ph.D., Assistant Professor, Department of Psychiatry & Behavioral Science at Stony Brook University School of Medicine…

Read the entire news article

Related articles

• Prescriptions for Antidepressants Increasing Among Individuals With No Psychiatric Diagnosis (cherished79.wordpress.com)
• Antidepressants Prescribed Without Psychiatric Diagnosis (webmd.com)
• Psychiatric Hospitalizations Increased Among Children And Teens, But Dropped Among Seniors (medicalnewstoday.com)
• In Defense of Psychiatric Medications, Part Two (psychologytoday.com)

AHRQ News And Numbers: Medication Side Effects, Injuries, Up Dramatically

From the 13 April 2011 Medical News Today article

The number of people treated in U.S. hospitals for illnesses and injuries from taking medicines jumped 52 percent between 2004 and 2008 – from 1.2 million to 1.9 million — according to the latest News and Numbers from the Agency for Healthcare Research and Quality. These medication side effects and injuries resulted from taking or being given the wrong medicine or dosage.

The federal agency also found that in 2008:

– The top 5 medicines that had more than 838,000 people treated and released from emergency departments were: unspecified medicines (261,600); pain killers (118,100), antibiotics (95,100), tranquilizers and antidepressants (79,300), corticosteroids and other hormones (71,400).

– For patients admitted to the hospital, the top five medicines causing side effects and injuries were corticosteroids (used for such illnesses as asthma, arthritis, ulcerative colitis, and other conditions–283,700 cases), painkillers (269,400), blood-thinners (218,800), drugs to treat cancer and immune system disorders (234,300), and heart and blood pressure medicines (191,300).

– More than half (53 percent) of hospitalized patients treated for side effects or other medication-related injuries were age 65 or older, 30 percent were 45 to 64, 14 percent between 18 and 44, and 3 percent under age 18. Children and teenagers accounted for 22 percent of emergency cases.

– About 57 percent of the hospitalized patients and 61 percent of emergency department cases were female.

This AHRQ News and Numbers is based on data in Medication-related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008. The report uses data from the agency’s 2008 Nationwide Inpatient Sample and 2008 Nationwide Emergency Department Sample. For information about these two AHRQ databases, go here.

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

Image via Wikipedia

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.”…

Related Articles

• Rehabilitation for Brain Trauma Patients (brighthub.com)
• Medical Consequences of Testicular Trauma in Childhood (brighthub.com)
• Vulnerable Patients May Lack Access to Trauma Care (nlm.nih.gov)
• Trauma Patients Fare Poorly After Hospital Discharge (webmd.com)
• Trauma patients have higher rate of death for several years following injury (physorg.com)
• Risk of hospital patient mortality increases with nurse staffing shortfalls, study finds(ScienceDaily)
• Military Funds Brain Injury Study: Immediate Nutrition Is Key (April 2011)

  Excerpt: Due to a high level of brain injury in the field, the United States Military commissioned the Institute of Medicine (IOM) to look into the best way to immediately treat traumatic brain injuries. The institute found that a quick infusion of calories, proteins and vitamins should now be a part of standard care in the military. This research will cross over into the public sector as well…
  

Hospital admissions due to dog bites increases by 86%

From a US Agency for Healthcare Research and Quality (AHRQ) Statistical Brief, Emergency Department Visits and Inpatient Stays Involving Dog Bites, 2008

The number of people admitted to the hospital because of dog bites increased by 86 percent – from 5,100 to 9,500 hospital stays – between 1993 and 2008.  Treating patients admitted for dog bites cost hospitals an average of $18,200 per patient and $54 million overall.

This report include tables and color charts with variables as insurance coverage, age of dog bite victims, principle diagnoses, and related procedures.

An overview of the  US Health Care Cost and Utilization Project(H-CUP) (from their Fact Sheet)

BackgroundThe Healthcare Cost and Utilization Project (HCUP) is a family of health care databases and related software tools developed through a Federal-State-Industry partnership to build a multi-State health data system for health care research and decisionmaking.

HCUP is sponsored by the Agency for Healthcare Research and Quality (AHRQ) as part of its mission to improve the quality, safety, efficiency, and effectiveness of the Nation’s health care system. This fact sheet summarizes current HCUP resources.

DatabasesHCUP databases contain a core set of clinical and nonclinical information found in a typical discharge abstract including all-listed diagnoses and procedures, discharge status, patient demographics, and charges for all patients, regardless of payer (e.g., Medicare, Medicaid, private insurance, uninsured). The information is translated into a uniform format to facilitate both multi-State and national-State comparisons and analyses.

Further details, future updates, and links to all HCUP databases are available at: http://www.hcup-us.ahrq.gov/databases.jsp.

Medicare finalizes new rules to require equal visitation rights for all hospital patients

From the November 17, 2010 US Department of Health and Human Services news release (http://www.hhs.gov/news/press/2010pres/11/20101117a.html)

The Centers for Medicare & Medicaid Services (CMS) today issued new rules for Medicare- and Medicaid-participating hospitals that protect patients’ right to choose their own visitors during a hospital stay, including a visitor who is a same-sex domestic partner.

“Basic human rights—such as your ability to choose your own support system in a time of need—must not be checked at the door of America’s hospitals,” said HHS Secretary Kathleen Sebelius.  “Today’s rules help give ‘full and equal’ rights to all of us to choose whom we want by our bedside when we are sick, and override any objection by a hospital or staffer who may disagree with us for any non-clinical reason.”

The new rules follow from an April 15, 2010 Presidential Memorandum, in which President Obama tasked HHS with developing standards for Medicare- and Medicaid-participating hospitals (including critical access hospitals) that would require them to respect the right of all patients to choose who may visit them when they are an inpatient of a hospital.  The President’s memorandum instructed HHS to develop rules that would prohibit hospitals from denying visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.  It also directed that the rules take into account the need for a hospital to restrict visitation in medically appropriate circumstances.

The rules require hospitals to have written policies and procedures detailing patients’ visitation rights, as well as the circumstances under which the hospitals may restrict patient access to visitors based on reasonable clinical needs.

A key provision of the rules specifies that all visitors chosen by the patient (or his or her representative) must be able to enjoy “full and equal” visitation privileges consistent with the wishes of the patient (or his or her representative).

The rules update the Conditions of Participation (CoPs), which are the health and safety standards all Medicare- and Medicaid-participating hospitals and critical access hospitals must meet, and are applicable to all patients of those hospitals regardless of payer source.

Among other things, the rules impose new requirements on hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner (including a same-sex domestic partner), or other type of visitor, as well as their right to withdraw such consent to visitation at any time.

“These rules put non-clinical decisions about who can visit a patient out of the hands of those who deliver care and into the hands of those who receive it,” said CMS Administrator Donald Berwick, MD, MPP.  “While we still have miles to go in making care more patient-centered, these rules make it easier for hospitals to deliver on some of the fundamental tenets of patient-centered care—care that recognizes and respects the patient as an individual with unique needs, who treated with dignity and granted the power of informed choice.”

CMS finalized the rules based on thousands of comments from patient advocates, the hospital community, and other stakeholders.  The rules will be effective 60 days after publication.  More information about the rules is available on CMS’ website at http://www.cms.gov/CFCsAndCoPs/06_Hospitals.asp and http://www.cms.gov/CFCsAndCoPs/03_CAHs.asp.

 

Hospitalizations for Medication and Illicit Drug-related Conditions on the Rise among Americans Ages 45 and Older

From an October 25, 2010 Agency for Healthcare Research and Quality (AHRQ) news release

The number of hospital admissions among Americans ages 45 and older for medication and drug-related conditions doubled between 1997 and 2008, according to a new report released today by the Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ). Medication and drug-related conditions include effects of both prescription and over-the-counter medications as well as illicit drugs.

Hospital admissions among those 45 years and older were driven by growth in discharges for three types of medication and drug-related conditions—drug-induced delirium; “poisoning” or overdose by codeine, meperidine and other opiate-based pain medicines; and withdrawal from narcotic or non-narcotic drugs.

Admissions for all medication and drug-related conditions grew by 117 percent—from 30,100 to 65,400—for 45- to 64-year-olds between 1997 and 2008. The rate of admissions for people ages 65 to 84 closely followed, growing by 96 percent, and for people ages 85 and older, the rate grew by 87 percent. By comparison, the number of hospital admissions for these conditions among adults ages 18 to 44 declined slightly by 11 percent.

“This report reveals a disturbing trend, and we need to find out more about why these admissions are increasing,” said AHRQ Director Carolyn M. Clancy, M.D. “As the average age of hospital patients continues to increase, so does the need for close monitoring of the types and dosages of drugs given to them.”

Drug-induced delirium or dementia can be caused by sleeping pills as well as drugs for urinary incontinence, nausea and other problems common in the elderly, but doctors sometimes cannot identify the cause. Poisoning by pain medicines or other drugs containing codeine, meperidine or other opiates can be caused by accidental overdosing or the failure to recognize the drug’s active ingredient. Drug withdrawal occurs when there is an abrupt withdrawal or significant reduction in the dosage of pain or other prescription medicines to which a person can become addicted, as well as of illicit drugs.

HHS’ Substance Abuse and Mental Health Services Administration helped support the analysis of the data in the report on hospital care for mental health and substance abuse disorders.”Substance abuse is rising, and drug abuse of all kinds is exploding as a major public health concern for our country,” said SAMHSA Administrator Pamela S. Hyde, J.D. “The challenge for our health care practitioners is to see that patients receive medications when there is medical need but also to help prevent the adverse health consequences from drug use.”

The new AHRQ report also shows that Medicare and Medicaid were responsible for 57 percent of the $1.1 billion cost to hospitals in 2008 for treating patients with medication and drug-related conditions, private insurance covered 24 percent, and the uninsured accounted for 14 percent. The remaining 5 percent of hospital costs for treating these conditions were borne by other sources such as TRICARE.

AHRQ’s report also includes data on other types of medical conditions treated in U.S. community hospitals, surgical and other procedures, and costs in 2008. For more information, go to HCUP Facts and Figures: Statistics on Hospital-Based Care in the United States, 2008 at http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/TOC_2008.jsp.

For more information, please contact AHRQ Public Affairs: (301) 427-1855 or (301) 427-1539.

Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/