The week’s focus on medical errors pointed out huge shortfalls in incident reporting systems and processes.
Many providers’ external communications plans were publicly shamed.
There is almost no support for doctors and nurses who make errors.
The research: Medical errors kill 1 in ~10 people in the United States, according to researchers from Johns Hopkins, published in the British Medical Journal. Media reports were often paired with tragic personal narratives.
“The absence of national data highlights the need for systematic measurement of the problem” wrote Makary et. al. They want to add “medical error” to death certificates, as primary or contributing factor.
Definition of medical error: an error in judgement, skill or coordination of care; a diagnostic error; a system defect resulting in death or a failure to rescue a patient from death; or a preventable adverse event.
Prince’s death marks a shift in our national psyche.
Our society is starting to view addiction as a chronic disease, not a moral failing.
Addicts are our friends and family. 44% of Americans know someone with an addiction to prescription painkillers.
GenX and late Boomers ages 45 to 64 account for 40% of all deaths from drug overdose. Prince’s death from opioid addiction put a public face on the problem of opioid addiction in this demographic cohort. Prince was 57.
Last year, an estimated 2.8 million seniors abused prescription drugs, as aging baby boomers are more willing to take prescription drugs than their parents’ generation.
Big Medicine is positioned as the bad guy in this fight.
Caregivers’ struggles against physicians over-prescribing opioids were documented in last year’s film “Take As Prescribed: Elderly Opioid Addiction.”
The American Medical Association stands against required training, since this will inject more government into their professions. The debate flared anew this week as the FDA considers requiring this training.
Evidence is piling up that pharmaceutical companies convinced doctors to prescribe painkillers in droves to treat pain. One memo was literally titled, “$$$$$$$$$$$$$ It’s Bonus Time in the Neighborhood!”
The “where does the money come from” question.
For care providers getting into the addiction treatment business, the costs are staggering: $15 billion in 2012. Costs fall disproportionately on the providers who treat Medicaid’s low-income population.
Private treatment companies expect reimbursement rates to rise. The cost of a week-long stay in a private addiction facility is $5,000 to $7,000 in Massachusetts.
Can coordinated care be a universal benefit?
“Elderly, Ailing, and Treated at Home” begins the Wall Street Journal op-ed about Independent at Home. “This is concierge care for the sickest, not the richest.”
The piece was authored by Ezekiel J. Emanuel. He advised President Obama in shaping the Affordable Care Act. He is also famously known for his manifesto, “Why I Hope to Die at 75.” This manifesto about his living will discusses the increases in disability that have accompanied increases in longevity.
Frail elderly people are 6% of Medicare patients and 30% of its spending. The pilot program is only open to 10,000 people, and Mr. Emanuel calls for taking the Independent at Home model nation-wide, and removing the 10,000 patient cap.
Frail seniors get more autonomy in California
In California, frail seniors will no longer be automatically enrolled in coordinated care pilot programs. They must sign up voluntarily.
Oakland’s Justice in Aging advocated for the change. Automatic enrollment confused and frustrated many beneficiaries… they didn’t know or understand that they had an entirely new insurance plan, with new doctors too.
Many seniors will not sign up because they lose their doctors, as acknowledged by patients and advocates alike. “Even the thought of losing a physician … is enough not to sign up.”
One change may help overcome this obstacle. Now, beneficiaries will keep their existing doctor for 1 year (versus 6 months previously) before they switch to doctors in coordinated care.
Curated with ♥ by Lisa LaMagna
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