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Hopital News

By: Mendy Hecht

July 27, 2018

Doc suspended for mistaking anxiety patient for ER abuser

Los Gatos, CA — An ER patient suffering symptoms of withdrawal from anxiety medication was mistaken by a veteran doctor for yet another ER abuser seeking unneeded treatment.


Footage of the physician berating the patient went viral, resulting in Dr. Keegstra’s suspension from El Camino Hospital in this Northern California suburb.


So-called “frequent flyers,” or patients who visit ERs excessively (usually for non-emergency or even non-medical needs), are a chronic problem plaguing ERs nationwide for years.


Frequent flyers commonly have no insurance and can’t afford to see a regular doctor, and also tend to have with mental-health and drug-abuse issues.  Studies have found that frequent flyers are likelier to be female, Caucasian, poor and between the ages of 25-44.


A 2009 study in Texas found that in a span of six years, nine patients had accounted for 2,678 ER visits, costing $3 million.


In 2015, Maryland’s Sinai Hospital identified 318 people who visited its ERA four times in as many months—referring them to primary care doctors, social services, mental health and substance abuse programs, and insurance providers.  That project cost the state $800,000 over three years—but resulted in 1,000 fewer ER visits and has since paid for itself.


More recently, officials in Indianapolis have launched a program that allows police officers to take people struggling with substance abuse issues, mental health problems and homelessness directly to a detox facility instead of jail or to a hospital ER.


Emergency-room spending rises with increasing prices, visit severity

Washington, D.C. — New research by the Washington-based Health Care Cost Institutes finds that costs of emergency-room (ER) visits by people with employer-based health insurance nearly doubled from 2009 to 2016—despite number of ER visits among that group staying level during that period.


According to the research, that near-doubling is due to the rising severity of ER visits and the accompanying rise in costs. 


The report found that ER-visit spending per person averaged $125 in 2009—but increased 98 percent by 2016 to $247.


Nurse-to-patient ratio laws back on front burner

Harrisburg, PA — It’s been a roiling debate in the hospital industry for decades.


On one side have been registered nurses (RNs) and their trade associations.  On the other are hospital industry groups.


The debate is over nurse-to-patient ratios—with nurses calling for years now for laws that cap the maximum number of patients that a nurse can be assigned to some specific low number.


Nurses and their advocates say that imposing per-nurse patient maximums for hospitals increases patient safety/care/attention, decreases nursing errors, and saves hospitals money.


Hospital executives, managers and associations argue the opposite—that a per-nurse maximum is a one-size-fits-all solution to a complex problem that will also cost hospitals more money.


The ratio model is now back on the front burner thanks to Pennsylvania, where Gov. Tom Wolfe has voiced support for new state legislation that would mandate a nurse-to-patient ratio.


Fourteen states currently have laws that address safe hospital nurse staffing, though California is the only one with a specific ratio law: five patients per nurse.  Seven other states require that hospitals set and enforce their own nurse-patient ratios, while five others require that hospitals publicly disclose their staffing ratios.


Furthering the case for ratio enforcement are studies pointing to high rates of burnout and turnover among nurses, and the resulting high industry costs—never mind patient safety. 


Hospitals rebut that staffing mandates would force hospitals to close, and that there aren’t enough nurses to hire, anyway. Both the American Hospital Association (AHA) and the American Organization of Nursing Executives (A-ONE) oppose any such mandate.


For now, the New York State Nurses Association is launching a $1 million ad campaign backing a ratio mandate bill that was shot down by the state’s Senate in 2016.


In the meantime, in most states where staffing legislation exists, policymakers have forged compromise between nurses and hospitals.