RedScrubs
The Resource for Medical Professionals

A recent study evaluated the relative cost and cost-effectiveness of percutaneous coronary intervention (PCI) in the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive drug Evaluations) trial.
Resource use was assessed by looking at the diagnosis-related group for hospitalizations and by current procedural terminology codes for outpatient visits and tests and then converted to costs by use of 2004 Medicare payments. Life expectancy beyond the trial was estimated from Framingham survival data.
The added cost of PCI was approximately $10,000, without significant gain in life-years or quality-adjusted life years. A larger minority of the distributions found that medical therapy alone offered better outcome at lower cost.

Will healthcare organizations raise the bar on transparency and start reporting adverse events in a public forum as they do costs, and other quality of care indicators?

Transparency, a word with several connotations: free from pretense or deceit, readily understood, characterized by visibility or accessibility of information especially concerning business practices. When healthcare organizations discuss the notion of transparency the later two descriptions exemplify the concept. Organizational transparency in healthcare has typically taken the form of selected quality of care indicators.

Scott MacStravic over at World Healthcare Blog authored a great piece the other day regarding the physician shortage and the use of mid-level providers as a means of improving access to care. I wanted to take an opportunity to echo Scott’s comments with this subject.

Headlines in the Sacramento Business Journal state “Study: Nurse staffing ratio hasn’t improved patient care”. The California Nursing Outcomes Coalition conducted the study to evaluate the quality of nursing since the advent of nurse patient ratio laws in California.

“The first study of the effect of nurse-to-patient ratios on care in California hospitals concludes hospitals have hired more registered nurses, but they’ve had little effect on two areas of care — patient falls and bed sores.”

Your in the middle of your shift, the nursing supervisor comes over to the group of nurses working and asks if anyone would like to stay and “do a double”. There is immediate silence, each nurse looks at the other and almost unanimously everyone turns back to the supervisor and signals a resounding “no”. In response the supervisor declares that someone has to be mandated.

Nursing salaries may be leveling out as reported by Advance for Nurses. An on-line study collected salary data of 7500 nurses across the United States which indicated that salaries may have reached a plateau. The report shows a $3000 drop in nursing salaries this year compared to 2007. There are other indicators that suggest the nursing shortage is also tapering off. Experts say that one reason is the large number of nurses that are at the top of their facility pay scale who are now only getting an annual cost of living adjustment.

Bad habits may get your fired. Over the last several months media sources have reported stories about companies that have targeted employees with bad habits. These so called targeted employees have found themselves in the cross hairs of company managers for termination. Termination solely based on “bad habits. Smoking is the favorite vice that has some companies up in arms. In an attempt to mitigate health benefit costs – at least the company’s out of pocket expenses – workers are losing their jobs because of their personal habits.

I am the proud father of twin boys who are 3 ½. They are very active and already have the abilities to play baseball, football, soccer and golf. Bryce has a mean fastball and Broc can tackle you like a pro.

After writing this story, we bought a Nintendo Wii. We purchased the Wii to provide entertainment for our friends and family. By introducing computers and other forms of technology now, I am hopeful that our children will have a competitive edge in the future.