ReportWire

Tag: Emergency Medicine

  • Cost concerns keep older adults from seeking emergency care

    Cost concerns keep older adults from seeking emergency care

    Newswise — Worries about what emergency care might cost them have kept some older adults from seeking medical attention even when they felt they might need it, a new study shows.

    In all, 22% of older adults who may have needed care from the emergency department didn’t go because of concerns about what they might have to pay, according to the new findings published in the American Journal of Managed Care.

    People in their 50s and early 60s, women, those who lack health insurance, people with household incomes under $30,000, and those who say their mental health is fair or poor were most likely to say they’d avoided getting emergency care because of cost concerns.

    The study, based on a survey conducted in June 2020, asked older adults to think back on the previous two years, including the first months of the COVID-19 pandemic.

    Even among those who hadn’t had a medical emergency in this time, worries about what an emergency visit might cost them were high. Four out of five older adults said they were concerned about the cost of emergency care (35% somewhat concerned and 45% very concerned, and 18% were not confident they could afford a visit.

    The data from the study come from the National Poll on Healthy Aging, based at the University of Michigan Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s academic medical center. The findings build on the poll report published earlier and are based on responses from a nationally representative sample of 2,074 people age 50 to 80.

    The findings confirm the experience of lead author Rachel Solnick, M.D., M.Sc., who trained in IHPI’s National Clinician Scholars Program before joining the faculty at the Icahn School of Medicine at Mount Sinai Health System in New York.

    “As an emergency physician, I have seen patients come to the emergency room having postponed their care. They often come in sicker than they would have been had they received care sooner,” she said. “That scenario is what I find most alarming in this survey’s findings. Some groups that are medically vulnerable or have suffered worse outcomes from COVID-19 were more likely to report cost-related avoidance of the ER than their counterparts. These findings highlight the importance of reducing the number of uninsured individuals and the need for insurers to clearly communicate coverage for emergency services.”

    Keith Kocher, M.D., the study’s senior author and an associate professor of emergency medicine at U-M, notes that the federal No Surprises Act was enacted after the study was done. That act seeks to reduce “surprise billing” for emergency care when a privately insured person receives it from hospitals or providers outside their health insurance plan’s network. At the time of the study, Medicare and Medicaid already prohibited emergency care providers from doing this kind of “balance billing.”

    Even so, a person with private insurance might owe hundreds of dollars in co-pays or deductibles for an emergency visit, the authors note. That’s especially true for people with high-deductible health plans, which are growing in enrollment.

    Even though the percentage of older adults who lack any health insurance is small (4% of the study sample), they were 35% more likely to say they were not confident they could afford emergency care. Solnick notes that both the pandemic’s economic impacts, and the decision by more than a dozen states including Texas and Florida to not expand Medicaid to all low-income adults, mean that millions of people may face paying out of pocket for emergency visits.

    American Journal of Managed Care, 2023;29(4): In Press, https://www.ajmc.com/view/older-adults-perspectives-on-emergency-department-costs-during-covid-19

    Michigan Medicine – University of Michigan

    Source link

  • Study reveals economic burden of gun violence

    Study reveals economic burden of gun violence

    Newswise — New Orleans, LA – A study led by Christopher Marrero, MD, Associate Professor of Clinical Orthopaedic Surgery at LSU Health New Orleans School of Medicine, reports that the net loss for treating acute firearm injuries at one Level I Trauma Center was $20.3 million over a four-year period. The results are published online in the American Journal of Preventive Medicine, available here.

                “Firearm injuries continue to plague the US as a serious public health problem, causing preventable death, illness, and disability,” notes Dr. Marrero. “They also continue to result in a major economic burden.”

                The research team conducted a retrospective study of patients with acute gunshot wounds admitted to the LSU Health New Orleans Affiliate Level 1 Trauma Center, University Medical Center New Orleans, from January 2016 to December 2019. A total of 2,094 patients met the criteria of acute firearm injury and were included in the analysis. Injuries included those caused by accidents, intentional self-harm, assault, legal intervention, and undetermined causes.

    The researchers tabulated the estimated costs and losses using the hospital cost-to-charge ratio. The estimated cost associated with treatment was $37,602,667. The total payment collected by the hospital was $17,293,655, resulting in a net loss of $20,309,012 over the four years.

    “When victims of firearm-related injuries are unable to pay their medical expenses, the hospitals write off unpaid medical bills as medical losses,” Dr. Marrero explains. “In this study, Medicaid dominated the payer makeup. This can also result in losses because Medicaid reimbursement does not fully cover costs. Per the American Hospital Association, Medicaid paid hospitals, on average, 90 cents for every dollar spent by hospitals caring for Medicaid patients in 2019. Because taxpayers fund Medicaid as well as Medicare, they bear the economic burden of these firearm injuries.”

                The authors observe that nonfatal firearm injuries are highest in the South, and Louisiana leads the US in the nonfatal firearm injury rate.

                They stress that when examining the financial impact of gun violence, it is important to also consider the costs associated with nonacute care such as follow-up visits, rehabilitation, secondary outpatient surgeries, home health, and durable medical equipment, which increase the total cost exponentially. The authors also point out economic burdens to society beyond medical expenses, including criminal justice expenditures, employer and work-loss costs, as well as intangible losses, such as diminished quality of life.

                “The estimated costs presented in this study show only a fraction of the economic burden associated with gun violence,” Dr. Marrero concludes. “In actuality, the financial impact of firearm injuries is much greater, and further research is necessary to find solutions for this public health issue.”

     

    LSU Health Sciences Center New Orleans educates Louisiana’s health care professionals. The state’s flagship health sciences university, LSU Health New Orleans includes a School of Medicine with campuses in Baton Rouge and Lafayette, the state’s only School of Dentistry, Louisiana’s only public School of Public Health, and Schools of Allied Health Professions, Nursing, and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena, the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent, advance treatment, or cure disease. To learn more, visit http://www.lsuhsc.edu, http://www.twitter.com/LSUHealthNO, or http://www.facebook.com/LSUHSC.                                                   

                                                             

    Louisiana State University Health Sciences Center – New Orleans

    Source link

  • 4 Ways the CSU Promotes Fire Safety

    4 Ways the CSU Promotes Fire Safety

    Newswise — October 9th kicked off the National Fire Protection Association’s 100th annual Fire Prevention Week. This year’s campaign, “Fire won’t wait. Plan your escape,” aims to raise awareness around how individuals can keep themselves safe in the event of a fire. In time for this long-running observance, we looked at ways the CSU is working to protect its students, faculty, staff and community in the midst of fires.

    1. Systemwide Resources

    The CSU’s Emergency Management team supports campuses through the creation of a broad range of systemwide resources, including guidance documents, webinar presentations and regular group brainstorming sessions that keep all campuses engaged and connected to one another. This network helps campuses access the information they need to make informed decisions around safety. The purview of the team, however, goes beyond fires to include other crises like earthquakes and the COVID-19 pandemic.

    “The CSU has unique campuses, unique geographies, unique cultures, and so it’s not a one-size-fits-all solution for our campuses,” says Jenny Novak, director of Systemwide Emergency Management and Continuity. “Our goal is to bring people together as much as we can to get people sharing good practices that they’re implementing on their campuses and lessons learned from incidents.”

    Recently, the team gathered an interdepartmental Wildfire Smoke Work Group to develop the Systemwide Wildfire Smoke Guide, which provides guidance for preparing for, responding to and recovering from a wildfire smoke event that impacts campus air quality. It includes references like websites that track air quality, good practices like which local partners to work with and regulatory information like requirements around personal protective equipment for campuses to consider when making decisions around operations and response.

    “The big issue historically has been smoke more than fire itself because the smoke has such a broad, regional impact compared to the fires,” Novak says. “When we put together a guide like this, we want to alleviate some of the campus burden by conducting the research and compiling it to give people a single place to look for information.”

    The team plans to create similar resources for wildfire recovery that will cover working with insurance providers, bringing in temporary facilities and technology and providing mental health care.

    1. Systemwide Emergency Support Team

    In the event of a regional emergency affecting multiple campuses, the Chancellor’s Office can activate its Systemwide Emergency Support Team to provide extra help.

    “It makes sense for us, especially, in a wildfire-type situation where there’s a lot of smoke over a very large area and we’re all seeing those impacts at the same time, because we want to have an idea of the number of campuses that are impacted,” Novak says. For example, the team activated for the first time during the 2020 wildfires, which impacted seven campuses, to coordinate response efforts.

    When activated, the Systemwide Emergency Support Team can use information gathered by the campuses to produce daily reports on their status, including academic operations, current fire threat and air quality. It will also schedule calls with campus partners to support decision-making and communications. But the team also helps campuses prepare for future emergencies through group exercises and training sessions.

    1. Office of Fire Safety

    Through the creation of the Office of Fire Safety five years ago, the CSU is gradually taking over the responsibility from the State Fire Marshal of ensuring campus facilities meet fire safety regulations and campus administrators are prepared for a fire emergency.

    “It was a conscious effort when this program at the CSU got started to make it centralized under the Chancellor’s Office to have a consistent approach systemwide from Humboldt to San Diego,” says Vincent Anderson, CSU deputy director of Fire Safety. “We’re going to have the same trainings and service delivery regardless of what zip code you’re in or which mascot is greeting you at the front gate. It is a humbling opportunity to be part of such a collaborative family between the Office of Fire Safety and the ​Capital Planning, Design and Construction Department (CPDC).​”

    By taking on this role, the Office of Fire Safety can customize the processes for inspecting, constructing and maintaining facilities to the university environment and academic schedule as well as make sure these processes are done in a timely manner. The office also works with campus partners to keep their protocols and practices up to date.

    “The main benefit to the campuses of our office is consistent, systemwide, time-effective fire safety programs tailored to the unique needs and uses of the CSU system,” Anderson says.

    The office will also conduct outreach to empower campus community members, including students and faculty, to ensure their own fire safety—an especially important task as campuses welcome a new cohort of students each year.

    “It’s building that safety ecosystem and that culture of safety through the public education piece—and again, tailoring it to the academic university,” Anderson says.

    1. Campus Emergency Management Programs

    Lastly, all 23 CSU universities have their own emergency management programs and emergency operations centers that respond to active emergencies and have notification systems to quickly communicate important information to the campus community. They also work with local partners, such as fire departments, to establish proper procedures and campus access for emergency personnel as well as perform outreach to develop a resilient campus culture.

    Check the Systemwide Campus Safety & Security page or the Systemwide Risk Management page for more information.

    California State University (CSU) Chancellor’s Office

    Source link

  • Witness says Rep. Ronny Jackson handcuffed and ‘briefly detained’ during rodeo while trying to assist with medical emergency | CNN Politics

    Witness says Rep. Ronny Jackson handcuffed and ‘briefly detained’ during rodeo while trying to assist with medical emergency | CNN Politics



    CNN
     — 

    Republican Rep. Ronny Jackson of Texas was handcuffed and placed on the ground face-first by local law enforcement while he was trying to assist a teenage girl in medical distress at a rodeo over the weekend, according to a witness who spoke to CNN.

    In a Facebook post, Linda Dianne Shouse, a home healthcare and traveling nurse, said her 15-year-old relative was “seizing due to possible hypoglycemia” Saturday night at the White Deer rodeo, about 45 miles northeast of Amarillo, Texas. Jackson represents the Amarillo area and was an attendee at the rodeo.

    Shouse said she and another family member, who is also a nurse, were attending to the girl when Jackson, who is an ER physician, stepped in to assist. Shouse said she didn’t know Jackson was a congressman at the time but told CNN they were all working together to help the teen girl.

    “We were just waiting for EMS to get there. The police came up, the deputies, highway patrol, and everyone was just screaming, ‘Get back, get back, get back,’” she said during an interview.

    Shouse said she was pushed back and then punched in the chest by a woman and said she saw a law enforcement official screaming in Jackson’s face, telling him to “Get the f**k back.”

    “He was trying to tell them that he was a doctor and probably trying to tell him who he was, to be honest. And they were screaming that they did not effing care who he was,” she said. “And the next thing I knew, they had him on the ground, grabbed him by the shirt, threw him on the ground, face first into the concrete and had him in cuffs.”

    Shouse said once they realized Jackson was a congressman and doctor, they uncuffed him and started apologizing.

    “We had the scene under control. We were just ready to give a report to EMS and get the patient out of there. And that’s not what happened,” Shouse said, recalling what she described as a “loud, chaotic” situation. “She wound up going eventually, but whenever you have someone laying there – when it could be neurological – time is on your hands.”

    In a statement provided to CNN, a spokesperson for Jackson said the congressman was “briefly detained” while trying to help the teenager. When Jackson approached the scene, a relative of the girl, who is a nurse, was assisting the 15-year-old. Jackson asked if the relative needed any help, and she said she did, according to the statement.

    “While assessing the patient in a very loud and chaotic environment, confusion developed with law enforcement on the scene and Dr. Jackson was briefly detained and was actually prevented from further assisting the patient,” the spokesperson said.

    His office believes he was detained for a matter of minutes. Jackson was released immediately when officers realized that he was tending to the medical emergency, the spokesperson said. Jackson’s office did not deny he was handcuffed during the incident.

    According to the Texas Tribune, Carson County Sheriff Tam Terry said in a statement that one person was “temporarily detained” at the rodeo on Saturday night and his department was “reviewing the incident.”

    CNN has reached out to Sheriff Tam Terry of Carson County for further comment. CNN has also reached out to the Texas Department of Public Safety.

    Jackson previously served as the White House physician for Presidents Barack Obama and Donald Trump. He retired from the US Navy as a rear admiral in 2019 and was elected in 2020 to represent the 13th Congressional District in Texas.

    Shouse said the girl is back in her hometown and undergoing further evaluation.

    Source link