Archives for hospitals



What Kind of Beer Is Most Likely to Land You in the E.R.?

A new study (gated) published in Substance Abuse & Misuse and summarized by Anahad O’Connor in The New York Times identifies the brands of beer most often drunk by people who end up in a hospital emergency room:

The study, carried out over the course of a year at the Johns Hopkins Hospital in Baltimore, found that five beer brands were consumed most often by people who ended up in the emergency room. They were Budweiser, Steel Reserve, Colt 45, Bud Ice and Bud Light.

Three of the brands are malt liquors, which typically contain more alcohol than regular beer. Four malt liquors accounted for nearly half of the beer consumption by emergency room patients, even though they account for less than 3 percent of beer consumption in the general population.

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Should Hospital Workers Who Don’t Get a Flu Shot Be Required to Wear a Mask?

A few weeks ago, before the flu was national news, a reader who works at a hospital in Portland, Or., wrote to say:
“The organization I work for just started this policy, I think it is very interesting and may push those who don’t want to get a flu shot for whatever reason to get a flu shot to avoid the stigma of wearing a mask. The employee comment section has ranged from HIPPA violations to discrimination for those who can’t have a flu shot based on egg allergies.”

Here’s the policy:

You may have heard by now: Flu season is ramping up in Oregon, with cases now starting to affect hospitalized patients in greater numbers. For individuals whose immune systems are compromised by other conditions, the flu can be life threatening.

To keep patients safe, a new Influenza Vaccination and Masking policy requires that workforce members do one of two things during flu season:

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When A Daughter Dies

Not too long ago, I wrote about my sister Linda, who passed away this summer.

Nobody could love a daughter more than my father Michael loved Linda. 

My father (who is a doctor) was realistic from the start about what modern medicine might be able to do to save his precious daughter from cancer.  Even with those low expectations, he was shocked at how impotent — and actually counterproductive — her interactions with the medical system turned out to be.

Here, in his own words, is my father’s poignant account of my sister’s experience with medical care. Read More »



Are High-Cost Hospitals Better Hospitals?

A new working paper (ungated here) by Joseph J. Doyle, Jr., John A. Graves, Jonathan Gruber, and Samuel Kleiner exploits the random assignment of ambulances to emergency care patients to determine whether higher-cost hospitals achieve better outcomes. From the abstract:

Ambulances are effectively randomly assigned to patients in the same area based on rotational dispatch mechanisms. Using Medicare data from 2002-2008, we show that ambulance company assignment importantly affects hospital choice for patients in the same zip code. Using data for New York state from 2000-2006 that matches exact patient addresses to hospital discharge records, we show that patients who live very near each other but on either side of ambulance-dispatch boundaries go to different types of hospitals. Both strategies show that higher-cost hospitals have significantly lower one-year mortality rates compared to lower-cost hospitals. We find that common indicators of hospital quality, such as indicators for “appropriate care” for heart attacks, are generally not associated with better patient outcomes. On the other hand, we find that measures of “leading edge” hospitals, such as teaching hospitals and hospitals that quickly adopt the latest technologies, are associated with better outcomes, but have little impact on the estimated mortality-hospital cost relationship. We also find that hospital procedure intensity is a key determinant of the mortality-cost relationship, suggesting that treatment intensity, and not differences in quality reflected in prices, drives much of our findings. The evidence also suggests that there are diminishing returns to hospital spending and treatment intensity.

The authors conclude that their results “should give policy makers some pause before assuming that spending can be easily cut without harming patient health, at least in the context of emergency care.”



Need to Go to the ER? Not Until the Game’s Over!

Sports fans are nuts, right? Prone to erratic, irrational behavior when their team is playing. You’d think that during the Big Game, violent behavior would spike, and maybe lead to higher rates of emergency room visits and even deaths? Not true. A number of studies show that big sporting events do not increase the number of patients admitted to emergency rooms, and in some cases, hospital visits and even heart attack rates have been shown to decrease during a major sporting event. Unless, of course, your team is losing.

The latest study in this vein, published this week in the Journal of Open Medicine, comes from Canada, where researchers examined emergency room visits during the 2010 Olympic gold medal ice hockey game between the U.S. and Canada. The game ended in a 3-2 overtime win by Canada and was seen by roughly half the country, some 16.6 million people, making it the most popular TV broadcast in Canadian history. The study found that the rate of total emergency room visits during the game decreased by 17 percent, compared with corresponding hours for 6 control days.

This effect extended throughout Canada’s largest province, amounted to a decrease of about 136 fewer patients per hour, appeared accentuated for adult men living in rural locations, and was most evident for those with milder triage severity scores presenting with abdominal pain, musculoskeletal disorders, or traumatic injuries.

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“If You Must Be Hospitalized, Television Is Not the Place”

I ran into an old friend the other day whose actor husband is a regular on the TV show House. We caught up on friends and family, etc., including a few mutual acquaintances who have died since we last spoke. As we parted, I couldn’t help but laugh: at least these unfortunate deaths, I thought, were nowhere near as numerous as those on the kind of TV show her husband appears on. Read More »



Reducing Hospital Bouncebacks

Zachary Meisel and Jesse Pines examine the issue of hospital “bouncebacks” — patients who return to the hospital shortly after discharge: “[B]ouncebacks are massively expensive-a recent study of Medicare patients found that one in five admissions results in a bounceback within 30 days of discharge, costing the federal government an estimated $17.4 billion per year.” Read More »



When Nurses Go on Strike

Patients die. Read More »