The Morning Report provides a quick look at today’s medical news, research and features.
5.17.13
| Which U.S. Hospitals Have The Highest Billing Rates? |
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The most expensive hospital in America is not set amid the swaying palm trees of Beverly Hills or the luxury townhouses of New York’s Upper East Side. It is in a faded blue-collar town 11 miles from Midtown Manhattan. Based on the bills it submits to Medicare, the Bayonne Medical Center charged the highest amounts in the country for nearly one-quarter of the most common hospital treatments, according to the New York Times.
Bayonne Medical typically charged $99,689 for treating each case of chronic lung disease, five times as much as other hospitals and 17 times as much as Medicare paid in reimbursement. The hospital also charged on average of $120,040 to treat transient ischemia, a type of small stroke that has no lasting effect. That was six times the national average and 24 times what Medicare paid.
For those prices, the quality of care at Bayonne Medical is no better – or worse – than that at most other New Jersey hospitals. In a 2011 state hospital quality report, Bayonne Medical scored only in the top 50 percent. But profits at the hospital, which was bankrupt in 2007, have soared in recent years, in part because it has found a way to turn some of those high billings into payments.
Other top billers in the country include: Crozer-Chester Medical Center, Upland, PA; Northbay Medical Center, Fairfield, CA; Doctors Medical Center, Modesto, CA; Hahnemann University Hospital, Philadelphia, PA; Washington Hospital, Fremont, CA; Temple University Hospital, Philadelphia, PA. |
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Surgical Residents Don’t Like Work Limits
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| Efforts to reduce residents’ sleep deprivation and stress with mandatory reductions in work hours have not been popular with hospital attending staff, and now a new survey suggests that the rules are equally unpopular among the residents themselves.
Two-thirds of surgical residents who responded to a survey said they objected to the 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements, wrote Brian C. Drolet of Rhode Island Hospital in Providence, and colleagues. In fact the rules are so unpopular that 20% of the 1,013 surgeons-in-training who answered the survey said that they falsified duty-hour records sometimes, 11% submitted fudged reports once a week, and 4% turned in faked reports daily, Drolet and colleagues reported online in JAMA Surgery. “The ‘spoiler’ is that 50.1% of surveyed surgical residents under-reported duty hours, 62.1% falsely reported duty hours, and only 32.4% acknowledged complying with the ACGME duty hour rules,” wrote Orlando C. Kirton, MD, from Hartford Hospital in Connecticut, in an invited critique. “This is extremely troubling behavior that could inevitably lead to unwanted scrutiny and stewardship action by Occupational Safety and Health Administration and Congress,” he wrote. “The ACGME rules are the law of the land. It is no longer about adoption but about adaptation and demonstrating resolve. Noncompliance is not an option and must not be encouraged.” (MedPage Today) |
| Military Suicides Linked to TBI |
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In research published in JAMA, investigators said higher suicide risk was seen in deployed military personnel who suffered repeated traumatic brain injuries, TBI, which became the signature battle injury of the wars in Iraq and Afghanistan. As many as one in five service members deployed to those war zones may have experienced TBI, from moderate cases to severe.
“Contributing to this heightened suicide risk is the concurrent rise in psychiatric illness among military personnel, especially among those exposed to combat operations,” wrote authors Craig J. Bryan and Tracy A. Clemans, of the National Center for Veterans Studies and U.S. Department of Veterans Affairs’ Research Education Clinical Center in Denver, respectively. “The risk of posttraumatic stress disorder, depression, and substance abuse is considerably increased among military personnel, with each being known risk factors for suicidal behaviors.”
In particular, TBI has been found to be associated in veterans treated by Veterans Affairs centers with significantly elevated risk for suicidal ideation, suicide attempts, and death, especially in combination with psychiatric and substance abuse problems. (Medical Daily) |