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As the June 30, 2004, date for the end to the emergency increase in the federal Medicaid match rate loomed, advocacy groups pushed Congress to extend the higher rate in recognition of the fact states still have significant financial problems and are dependent on the extra federal funds.
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In this article, a leading expert in the area of improving health care quality argues that restricting visiting hours in ICUs is neither caring, compassionate, nor necessary.
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Clinicians have been criticized for prescribing too much, as well as too little, sedation for critically ill patients, especially patients who require mechanical ventilation. Over-sedation may prolong weaning from ventilatory support, increase ICU and hospital lengths of stay, and predispose to development of ventilator-associated pneumonia. Inadequate sedation predisposes the patient to pain and discomfort and can evoke a stress response that compromises recovery.
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Erythromycin and the Risk of Sudden Death; Vaccine Shortage Putting Americans At Risk; FDA Actions.
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In this study of anonymously reported adverse occurrences related to intra-hospital transportation of critically ill patients, problems were related to equipment in 39% and to patient/staff management issues in 61%; 31% of the incidents had serious adverse outcomes.
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During a 5-year period, 45 patients were admitted to an inner-city teaching hospital with angioedema caused by angiotensin-converting inhibitor medications, and 18 (40%) of them required ICU admission for potential upper-airway compromise.
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While the federal government and states alike tout the flexibility state Medicaid programs get through use of waivers, a Kaiser Commission on Medicaid and the Uninsured study of the impact of Oregons Medicaid waiver raises red flags for states to consider as they implement waiver provisions to control Medicaid spending.
