Diverting Patients Away From Crowded EDs Tied to Higher Mortality Rates and Medi-Cal To Face Hit From End of Stimulus Funding, Budget Cuts

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Tue Jul 12 17:28:01 PDT 2011



June 14, 2011
Diverting Patients Away From Crowded EDs Tied to Higher Mortality Rates

California Healthline
High levels of ambulance diversion -- which occurs when overcrowded
emergency departments temporarily close to traffic -- are associated
with a 3% higher risk of death among patients experiencing heart
attacks, according to a study published in the Journal of the American
Medical Association, HealthDay/USA Today reports (Preidt,
HealthDay/USA Today, 6/13).

Ambulance diversion is a common tactic used to reduce ED overcrowding.
In the U.S., one ambulance is rerouted away from the nearest hospital
every minute, according to the National Center for Health Statistics
(Joelving, Reuters, 6/13).

For the study, Renee Hsia of UC-San Francisco and other researchers
examined data from 2000 to 2005 for 13,860 Medicare beneficiaries who
were admitted to EDs for heart attack symptoms in one of four
California counties: Los Angeles, San Francisco, San Mateo or Santa
Clara. Within each hospital, they compared death rates across varying
levels of ED crowding.

Key Findings
According to the study, ambulance traffic on average was rerouted from
the nearest ED to another hospital about 7.9 hours daily.

Researchers also found that patients whose nearest ED diverted
ambulances for 12 hours or more had a death rate of 19% after one
month, compared with a 15% death rate among those who received care at
the nearest hospital.

The gap persisted after three months, nine months and one year
(HealthDay/USA Today, 6/13).

Conclusions
The study authors noted that the evidence was inconclusive and proved
only an "association" between higher death rates and ambulance
diversion (Reuters, 6/13).

Researchers also suggested that targeted interventions are needed to
adequately distribute resources to decrease ED overcrowding and
ambulance diversion, so patients are not adversely affected
(HealthDay/USA Today, 6/13).
 
 


June 30, 2011
Medi-Cal To Face Hit From End of Stimulus Funding, Budget Cuts

California Healthline
 
Medi-Cal is poised to take a major financial hit as billions of dollars in federal stimulus funding run out on Friday and state officials await federal approval for about $1.4 billion in new cuts to the program, the San Francisco Chronicle reports. Medi-Cal is California's Medicaid program.

Stimulus Funds Run Dry
Under the 2009 federal economic stimulus package, the federal government increased its Medicaid matching rate from 50 cents on the dollar to 62 cents on the dollar.

Over the last two years, California has received about $12.4 billion of the $90 billion that the Obama administration pumped into Medicaid programs across the country to counter the effects of the economic downturn. The higher federal matching rate expires on Friday.

State Awaits Approval for Medi-Cal Cuts
Partly in response to the end of the federal stimulus funding, California lawmakers have approved Medi-Cal cuts as part of a budget package for the new fiscal year that begins Friday.

Some of the Medi-Cal changes include:
	• A new $5 copayment for physician visits and a $3 copay for prescriptions;
	• A limit of seven physician visits annually, unless a physician certifies additional visits as being medically necessary;
	• A $50 copay for emergency department visits and a $100 daily copay for hospital stays, up to a maximum of $200; and
	• A 10% reduction in Medi-Cal reimbursements to health care providers.

In addition, beneficiaries of Healthy Families -- California's Children's Health Insurance Program -- would face higher copays and premiums when the budget cuts take effect.

Although the cuts originally were slated to take effect on Friday, federal officials first must approve the changes. State officials then must provide a 60-day notice to Medi-Cal beneficiaries before the changes can be implemented (Colliver, San Francisco Chronicle, 6/30).

Additional Health-Related Cuts To Take Effect
When the budget for the new fiscal year begins on Friday, changes to other health and human services programs will take effect. Some of the changes include:
	• The elimination of California's adult day health care program, which could be replaced with a similar program that would serve fewer beneficiaries;
	• Cuts to California's In-Home Supportive Services program, which could mean that about 436,000 IHSS beneficiaries would lose about 16.5 hours monthly of in-home assistance; and
	• Funding reductions to services for people with developmental disabilities.
Under the budget plan that the Legislature passed for the upcoming fiscal year, California could enact further cuts to health and human services programs if the state fails to receive a projected $4 billion in higher-than-expected


Read more: http://www.californiahealthline.org/articles/2011/6/30/medical-to-face-hit-from-end-of-stimulus-funding-budget-cuts.aspx#ixzz1QoUjgt7P

 
 

 
Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

 
 
Contact us at: calaaem.news.service1 at gmail.com

For more articles, visit our archives. 

To unsubscribe from this list, visit our mail server.

Copyright (C) 2011. The California Chapter of the American Academy of Emergency Medicine (CAL/AAEM). All rights reserved.

CAL/AAEM, a nonprofit professional organization for emergency physicians, operates the CAL/AAEM News Service solely as an educational resource for physicians. Dissemination of an article by CAL/AAEM News Service does not imply endorsement, agreement, or recommendation by CAL/AAEM News Service, CAL/AAEM, or AAEM.
 
 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://maillists.uci.edu/mailman/public/calaaem/attachments/20110712/f7a501b8/attachment.html 


More information about the CALAAEM mailing list