FHI's Week in Review

Volume V, Issue 50

Dec. 10, 2018

Florida, California lead Leapfrog's Top Hospitals list

Meg Bryant reports for Healthcare Dive on 12.5.18:

The Leapfrog Group released its 2018 Top Hospitals list Tuesday, with Florida's 18 awardees bumping last year's list leader California into second place with 17 top hospitals. Texas and New Jersey also had strong showings, with 13 and 12 top hospitals, respectively.

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Given its large population, one would expect Florida to be near the top of the rankings. That said, the #1 ranking is impressive. Why? According to data compiled by the American Hospital Directory (updated Summer 2018), Florida has 216 hospitals and 55,429 staffed beds. Meanwhile, California has 343 hospitals and 74,762 staffed beds. Texas has 367 hospitals with 59,329 staffed beds.

Statins are one of the most commonly prescribed drugs; This study suggests doctors rethink their use.

Joanne Finnegan reports for Fierce Healthcare on Dec 4, 2018:

A new study suggests that doctors may be prescribing statins-one of the most commonly prescribed drugs worldwide-to too many of their patients. In the study, published in the Annals of Internal Medicine, researchers from the University of Zurich in Switzerland used a computer model to examine the benefits and harms of the cholesterol-lowering drugs. They found that statins may be overprescribed for the primary prevention of heart disease. That's because potential risks seem to outweigh the benefit for people whose 10-year cardiovascular disease risk is 7.5% to 10%-which is what the guidelines currently recommend.

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The researchers said that prescribing for only those patients at higher risk thresholds would mean that millions of people would no longer be eligible for statin therapy. The study suggests that 15% to 20% of older adults should take statins-far less than the 30% to 40% of older adults who now fall within suggested medical guidelines.

Money will be lost in healthcare

Dr. Edwin Leap, an ED doctor, offers some sobering thoughts on the state of our health system in a Dec. 3, 2018 KevinMD post:

I mean, we're constantly reminded that satisfaction scores, and time-stamps and time to door, time to needle, time to discharge, reduced "left without being seen" scores are connected to the money we make. Medicine now is far less about the wonder of the body, the ravages of disease, the delight of the diagnosis and the thrill of healing. Medicine, now, is clicks and time-stamps, clipboards and strategies, through-put, input, out-put, put-out, burned out.

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According to the author:

I don't know about all of the house of medicine. But I do know this. When we, in the emergency departments of the U.S., see everyone at all hours, regardless of payment, then money will be lost...No matter what you do with the rules and time expectations, the satisfaction scores, the consulting schemes, the computer programs or anything else, eventually you're faced with the reality that you're giving away care. Sometimes to those who really need it. Often to those who don't.