STI's on the Rise

A recent report by the CDC demonstrates that chlamydia, gonorrhea and syphilis rates are continuing to rise in the United States! Syphilis which was almost completely eliminated, is making a ressurgence, particularly in homosexual males.

Trends demonstrate that adolescents and young adults, as well as minority groups, particularly African Americans, have the greatest burden of these infections. Read more at the following link.

http://www.reuters.com/article/healthNews/idUSTRE5AF14A20091116

Who Can Get the Flu Vaccine?

It has recently been reported that large corporations such as Goldman Sachs and Citigroup have received hundreds of doses of the coveted H1N1 vaccine. Further, while many retail locations, such as Walmart, CVS, etc, have had supplies of seasonal flu vaccine for those who line up and pay for the vaccine, less commercially associated locations such as physician offices (my pediatrician office included) have yet to receive their allotment of vaccine. Thus one must question -- how does this distribution occur?

A related online article noted that despite significant searching, the authors were unable to locate doses of H1N1 vaccine on eBay or Craig's list; further, when he (and his assistants) contacted physician offices offering to pay top dollar for what would otherwise be a free vaccine (provided by the government), the general response was that the vaccine could not be bought by the highest bidder. And yet, these large corporations, who claim to be giving the vaccine to those on the "high priority" list, are able to obtain hundreds of doses.

Thus begging the question -- how do we monitor the distribution?

http://www.google.com/hostednews/ap/article/ALeqM5jemnWB5veRnM9evI2vqkMks9HwkwD9BPM93G0

New Strain of MRSA is Deadly and More Resistant

Researchers have identified a new strain of methicillin resistant staph aureus (MRSA) that appears to be up to 5 times more deadly than other known strains. This strain, USA600, seems to have some resistance to vancomycin (the antibiotic that is typically effective against other MRSA strains) and about one-half of those infected with the strain have died.

The message remains the same -- wash your hands, wash your hands, wash your hands. In addition, no sharing personal items!!

http://www.healthday.com/Article.asp?AID=632611

Ratings Do Matter

According to a recent study of Medicare hospitalizations from 2006 - 2008, patients in a 5 star hospital have a 71.64% lower risk of dying than those at a 1 star hospital! About 57% of potentially preventable hospitals deaths were associated with the following: sepsis (massive infection), pneumonia, heart failure and respiratory failure.

In considering full report of the study, we do find that PA does have one of the highest percentages of top 15% hospitals for cardiac surgery. However, the majority of PA's hospitals fall in the middle 70% of ranked hospitals. Overall, of the 161 PA hospitals studied, 15.53% were among the top 15% of the country, 73.29% are in the middle 70% and 11.18% are in the bottom 15% of the countries hospitals (one star facilities).

So how do you find out where your local hospital ranks? First, hospitals are ranked overall and also based on speciality (for example, cardiac surgery, stroke, gastrointestinal, pulmonary, etc).
As we've discussed, there are online "hospital rankings" but they can be difficult to understand. Health Grades is one example: http://www.healthgrades.com/find-a-hospital

How We Rank!

Watch the following YouTube video to see how the US ranks in terms of "World Health."

http://www.youtube.com/watch?v=yVgOl3cETb4

Obama Addresses Congress

Hopefully, many of you either watched or have read the President's Healthcare Reform address. In particular, it was very interesting to me as he discussed the proposed insurance market place. Consider this market place in relation to the German Sickness Fund system. While the details on the Insurance Market place are few, there do seem to be some similarities in how they would function. Keeping costs down through competition for subscribers is just one of those similarities. As you can learn from watching the Frontline "Sick Around the World" video clips (http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/), we have much to learn from the way in which other countries conduct the business of health care -- a single payor plan is NOT the only option and is not likely an option that would adequately meet the diverse needs of the American public.

However, though the details on the how the overall plan would function are few, the details on the methods of paying for a revised system are also few. In his speech, President Obama referred to trimming the waste from existing programs and, in my opinion, if done correctly, this could result in millions of saved dollars. As an RN care coordinator, I have too often seen an insurance company reject payment for the lower cost option (for example in home intravenous antibiotics) but approved payment for the same treatment to be provided as an inpatient stay -- at a MUCH higher price. Reviewing acceptance criteria and reviewing the existing insurance regulations to better reflect evidence based practice is needed to move forward with healthy healthcare reform.

If you did not see or read the speech, see the link below. You can watch the address, read the address and see an outline of the plan.

http://www.whitehouse.gov/issues/health_care/

Living Longer in the US

According to our most recent statistics, for a child born in the US in 2007, the average lifespan will be nearly 78 years old. While our average lifespan does continue to increase in slow increments, the US still lags behind 30 other countries for average lifespan. However, we are near the front of the pack for per capita expenditures for healthcare.

http://news.yahoo.com/s/ap/20090819/ap_on_he_me/us_med_life_expectancy

Swine Flu May Be Harder to Stop Than a Greased Pig

Swine flu, or H1N1, is rapidly spreading worldwide. Like the pandemic 1918 flu, the cases of H1N1 flu that we saw early in 2009 were merely the precursor to what has the potential to become a major health crisis. Several years ago, avian flu (H5N1) threatend to create a pandemic in humans; however, human to human transmission of that virus never occurred. Already, H1N1 has demonstrated its incredibly efficient ability to spread rapidly among humans.

While 60% of deaths from H1N1 are predicted to be in those individuals with debilitating and/or chronic conditions, 40% of deaths will occur in healthy people -- with the young and middle age adults most likely to be affected! College populations will be among those most at risk -- so. . . .wash your hands, wash your hands, wash your hands.

http://www.google.com/hostednews/afp/article/ALeqM5hYCBp4bPYUGtZwMUlvNaMJxSlOng

911 Makes House Calls?

If you have followed the healthcare reform debate, you have no doubt heard that many without adequate insurance often use emergency room treatment as a form of primary care -- going to the ER to receive treatment that would more appropriately be rendered in a clinic or office. What you may not have heard about is the rising volume of non-emergent 911 calls. As the linked story highlights, the cost of these calls is very high as EMTs are required to respond to every health-related 911 call. This service if funded through taxes and other fees paid by the American public.

http://money.cnn.com/2009/08/24/news/economy/healthcare_911_abuse/index.htm

Taking the "Yuck" out of CPR

Continuing healthcare research is demonstrating that chest compressions only (no mouth to mouth) may be just as effective, if not more effective than traditional CPR. As you'll see in the attached article, thousands of victims of a sudden cardiac event do not receive timely treatment because bystanders are uncomfortable or unfamilar with CPR procedures. Would knowing that you only need to perform chest compressions make you more likely to assist someone in an emergency? Remember, activating 911 and getting an AED on the scene is still the number one priority. Do you know where the AEDs are located on campus or in your neighborhood?

http://news.yahoo.com/s/hsn/20090824/hl_hsn/itsbacktobasicstosavealife

Healthcare or Health Crisis

Health care reform has quickly become one of the most talked about political initiatives. Health care reform will affect every American -- how much do you know about the plans being discussed and debated? How will the proposed legislation affect you? As you watch the news, read web updates and listen to other discuss health care reform, how do you know what is the reality and what is hyperbole meant to distract, mislead or "spin?" I believe we must listen with an open-mind but further, we must do our own research and analysis. Various fact checker sites are available. The link below is the American Nurses Association's (ANA) commentary on the proposed legislation; while not entirely unbiased (ANA has long been a supporter of health care reform), it does provide a description of some of the major points of contention in the plan, along with a fact-based discussion of those points. I encourage you to use this document as a stepping stone to learning more about US health care reform!

http://www.rnaction.org/site/DocServer/HCR_Myth_Fact.pdf?docID=461