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The severe nationwide shortage of killed flu vaccine has put a stop, at least temporarily, to initiatives in some places that would force health care workers to be vaccinated or risk their jobs, but some health care experts warn that the solution advocated by at least one state that health care workers forego the vaccine entirely so that more is available for higher-risk groups could be dangerous to the very people it aims to protect.
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For the emergency physician, sexual assault represents the most common presenting complaint associated with the potential for an unintended pregnancy. Annually, approximately 40,000 people in the United States visit EDs after sexual assault. Pregnancy is estimated to occur in approximately 5% of sexual assaults. Thus, pregnancy prevention is an important part of the care for these patients. For the emergency physician, EC represents the most viable treatment option. However, while highly effective when used properly, it is associated with a number of issues that make it much less commonly used.
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Case managers with the Hawaii Medical Service Association (HMSA), a nonprofit medical indemnity association, follow a practice model that differs significantly from that used at most other insurance companies, says Melissa Bojorquez, ACBSW, MBA, CCM, supervisor for the HMSA case management program.
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The movement to prevent wrong-site or wrong-person surgery got another boost recently when a major health plan announced affective Jan. 1, 2005, it will no longer pay for medical procedures involving those egregious errors. Dont expect to get paid for a procedure if you leave that 12-inch retractor in the patients belly, or the next procedure to remove it.
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A pediatric asthma program that includes home visits by an asthma management team and an intensive educational program for families has resulted in a dramatic drop in emergency department (ED) visits for pediatric asthma patients at Hurley Medical Center in Flint, MI.
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Hospital discharge planners often have to use their ingenuity in finding placements for patients with no insurance who need post-acute services or are homeless and need a place to stay. The problem is that patients must be discharged safely, whether or not they have money to pay for the services they need.
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A team approach and intensive case management of patients has helped San Francisco General Hospital cut the number of hospitalizations and costs for patients who were frequently hospitalized.
