Jul 20, 2010

What? 80% of ED patients have insurance?

Wow!  When I first read this I thought "no way" -it's got to be more than that!  We've all heard it before, "ED patient's don't have insurance - that's why they come to the ED in the first place".  Well information relased by the Federal HHS Department shows that lack of insurance in our ED population is the minority when all is tallied up.  

Original article can be found at: http://tinyurl.com/20percent-uninsured

New Data Say Uninsured Account for Nearly One-Fifth of Emergency Room Visits

July 16, 2010

HHS Secretary Kathleen Sebelius today released new data from the Nationwide Emergency Department Sample -- the largest, all-payer emergency department database in the United States.  The Nationwide Emergency Department Sample is designed to help public health experts, policymakers, health care administrators, researchers, journalists and others find the data they need to answer questions about care that occurs in U.S. hospital emergency departments.

These data indicate that uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. 

"Our health care system has forced too many uninsured Americans to depend on the emergency room for the care they need," said Secretary Sebelius. "We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies."

The database is managed by HHS' Agency for Healthcare Research and Quality (AHRQ) and generates national estimates on the number of emergency department visits in all community hospitals, by region, urban/rural location, teaching status, ownership and trauma designation.  It also provides in-depth information on acute management of patients for all visits, including why patients were seen in the emergency department, the treatments they received, what happened to them at the end of the visit (admitted to the hospital, discharged home, transferred to another hospital, died in the emergency room or left against medical advice), the charge for their care and who was billed.

The Nationwide Emergency Department Sample contains 26 million records from emergency department visits from approximately 1,000 community hospitals nationwide.  This represents 20 percent of all U.S. hospital emergency departments.  The database also provides weighted calculations for national estimates of the 120 million emergency department visits in 2006.
"AHRQ has a long history of supporting health services research related to emergency medicine, and the richness of these new data will increase our capacity for research and decision making," said AHRQ Director Carolyn M. Clancy, M.D. "The new database will give emergency planners and other policymakers the data they need to help improve the quality, safety and effectiveness of emergency medical care."  

AHRQ also released its latest Nationwide Inpatient Sample-- the largest, most powerful database on hospital care in the United States, covering all patients, regardless of their type of insurance or whether they were insured. The 2007 Nationwide Inpatient Sample provides users with an in-depth look at why patients were hospitalized, the treatments and procedures they received and what happened to them at discharge. Researchers can use the Nationwide Inpatient Sample to examine trend data as far back as 1988. The 2007 Nationwide Inpatient Sample is based on discharge data from 8 million hospital stays at more than 1,000 community hospitals.

The two databases, as well as the 2006 Kids' Inpatient Database on pediatric inpatient care, are part of AHRQ's Healthcare Cost and Utilization Project (HCUP), a federal-state-industry partnership for building a standardized, multi-state health data system. In addition to databases, HCUP includes software tools and statistical reports to inform policymakers, health system leaders, researchers and the public.

HCUP databases can be accessed by using the AHRQ on-line query tool, HCUPnet. Researchers and analysts who need the most in-depth data should contact the HCUP Central Distributor about purchasing the 2006 Nationwide Emergency Department Sample and the 2007 Nationwide Inpatient Sample datasets and for further information about their composition and technical requirements.

Jul 15, 2010

Health Care Reform Might WORSEN ED Crowding

Reform To Exacerbate Emergency Department Crowding, Experts Say

The new health reform law might exacerbate emergency department overcrowding, according to health care facility experts, The Hill reports.

Advocates of the overhaul said the law would help address ED overcrowding by ensuring more U.S. residents had insurance to cover physician visits.

However, EDs likely will experience higher patient volumes over the next four to eight years because of a dearth of primary care physicians in the U.S., according to Rich Dallam, a partner at health care architectural firm NBBJ.

Lessons From Massachusetts?
Rep. Jim McDermott (D-Wash.) agreed that increased stress on EDs is a possibility. He pointed to Massachusetts, where a 2006 health law that created near-universal health coverage for state residents has failed to abate ED demand

 A recent American College of Emergency Physicians poll found that nearly two-thirds of Massachusetts residents said ED wait times have increased or remained the same since the law was enacted.

In addition, a report by the Council of State Governments released in February found that wait times had not declined since Massachusetts' law took effect.

Jul 6, 2010

Fireworks Related Mortality Report

(NOTE: The data for 2009 and 2010 has not been compiled yet)
Below are some interesting factoids about fireworks related mortality.

     This report provides the results of the U. S. Consumer Product Safety Commission (CPSC) staff analysis of data on non-occupational fireworks-related deaths and injuries during 2008. The report also includes a summary of CPSC staff enforcement activities during 2008.
     Staff obtained information on fireworks-related deaths from news clippings and other sources in CPSC’s Injury and Potential Injury Incident (IPII) database. Staff estimated fireworks-related injuries from CPSC’s National Electronic Injury Surveillance System (NEISS). More detailed analyses of injuries including the type of injury, the fireworks involved, and the characteristics of the victim were based on a special study conducted by CPSC staff between June 20 and July 20, 2008. About two-thirds of the annual fireworks-related injuries for 2008 occurred during that period.

Highlights of the report are as follows:
•CPSC staff has reports of 7 fireworks-related deaths during 2008. Two people were killed in incidents involving aerial and display fireworks. One person died in a fire where a firework was the ignition source. Three people were killed in incidents involving homemade fireworks. One person, on oxygen, suffered serious burns when a firecracker exploded near his face. He died 18 days later in the hospital. CPSC staff has reports of 11 fireworks-related deaths in 2007.

•Fireworks were involved in an estimated 7,000 injuries treated in U. S. hospital emergency departments during calendar year 2008 (95 percent confidence interval 5,200 – 9,000). CPSC staff estimated that there were 9,800 fireworks-related injuries during 2007.

•An estimated 5,000 fireworks-related injuries (or 70 percent of the total fireworks-related injuries) were treated in U.S. hospital emergency departments during the one-month special study period between June 20, 2008 and July 20, 2008 (95 percent confidence interval 3,400 – 6,500). CPSC staff estimated that there were 6,300 fireworks-related injuries (66 percent of the annual total) during the 2007 special study period.

Results from the special study include the following:
•Of the fireworks-related injuries sustained, 62 percent were to males and 38 percent were to females.

•Injuries to children were a major component of total fireworks-related injuries with children under 15 accounting for 40 percent of the estimated injuries. Children and young adults under 20 had 58 percent of the estimated injuries.

•There were an estimated 900 injuries associated with firecrackers. Of these, 500 were associated with small firecrackers, 100 with illegal firecrackers, and 300 where the type of firecracker was not specified.

•There were an estimated 800 injuries associated with sparklers and 300 with bottle rockets.

•The parts of the body most often injured were hands and fingers (estimated 1,400 injuries), eyes (1,000 injuries), and legs (900 injuries).

•More than half of the injuries were burns. Burns were the most common injury to all parts of the body except the eyes, where contusions, lacerations, and foreign bodies in the eye occurred more frequently.

•Most patients were treated at the emergency department and then released. An estimated 8 percent of patients were treated and transferred to another hospital or admitted to the hospital.