Beshear says no for second time to University Hospital merger

For the second time, Gov. Steve Beshear has rejected a proposed merger for Louisville's University Hospital, saying he still didn't think ideas suggested in a meeting last week would be enough to allay his concerns. Beshear said no to a controversial proposal Dec. 30 that would have merged University Hospital with Jewish Hospital & St. Mary's HealthCare and St. Joseph Health System.

Beshear would not go into details about what ideas University Hospital officials presented last week, saying only that he remains "committed to working with the university to explore all appropriate paths forward for the hospital and for our Kentucky taxpayers," Patrick Howington and Laura Ungar report for The Courier-Journal.

The merger would have give majority control to St. Joseph, which is owned by Catholic Health Initiatives, so all three health systems would have been subject to Catholic health directives. Jewish & St. Mary's and St. Joseph announced last Friday they will merge without University Hospital and call the system KentuckyOne Health. Beshear said he rejected the merger because it would mean the loss of control of a public asset and raised "constitutional church-and-state issues," Howington and Ungar report. (Read more)

C-J finds gaps in medical care for female soldiers, vets

Though women now account for almost 15 percent of active-duty troops in the U.S. military, the medical care they receive is often not on par with that of their male counterparts.

A 2007 Department of Defense report showed that "In half of focus groups, women expressed concerns about a lack of female-specific facilities and equipment, such as machinery to perform mammograms, in field hospitals," The Courier-Journal's Laura Ungar reports. Department of Veterans Affairs "hospitals don't provide obstetrics, for example, and most don't offer mammograms on-site."

Military officials acknowledge more needs to be done, but progress is being made. "Are we perfect? No. But we work our hardest to be," said Laura Boyd, public affairs officers for Fort Campbell's Blanchfield Hospital.

Efforts are being made to boost privacy for women and improve training. The VA has also hired managers to handle women's care and has launched an awareness program in which employers are reminded to assume that any woman who walks in is a veteran. Spending has also gone up, with the VA asking for $270 million in 2012, up $28 million from last year.

Still, the 2007 report found medical care was wanting in field centers. Women complained "about limits on access to gynecological exams, procedures and lab tests; and too few birth-control options in field pharmacies," Ungar reports. "In nearly half the focus groups, women said there was too little privacy in field facilities, and many felt they were seen as whiners for seeking care."

Officials at Blanchfield admit they can't provide all the care women need and do rely on outside providers, such as Vanderbilt University, for complicated cases and for routine wellness services. Most outside providers are within an hour's drive of a VA facility, which Patty Hayes, the VA's director of women's health, acknowledged is "not ideal." Still, there are no plans to provide obstetrics or other specialty care for women at VA hospitals. (Read more)

Penny-per-ounce tax on sugar drinks could save $17 billion, cut consumption and prevent disease and death, academics say

More than $17 billion in medical costs over 10 years could be saved if sugared drinks were taxed at 1 cent per ounce, and it would prevent 95,000 cases of coronary heart disease, 8,000 strokes and 26,000 premature deaths, say researchers at Columbia University and the University of California.

The tax would mean an extra 12 cents per can or 20 cents per bottle, and would generate about $13 billion in annual tax revenue. The study, published in this month's HealthAffairs, found the consumption of sugary drinks, including soda, sports drinks like Gatorade and energy drinks like Red Bull, would be cut by 15 percent among adults ages 25 to 64.

"Even our conservative estimates show that a penny-per-ounce tax on sugar-sweetened beverages could substantially reduce the negative health and financial impacts of obesity, diabetes and cardiovascular disease," said Dr. Y. Claire Wang, assistant professor at the Mailman School of Public Health at Columbia  and lead author of the study. "Putting the money raised by the tax into efforts to prevent obesity and other health problems could potentially increase the impact of such a policy."

In 2009, Americans consumed 13.8 billion gallons of sugar-sweetened beverages, which translates to about 45 gallons per person. The average 20-ounce bottle of a sugar drink contains almost 17 teaspoons of sugar. (Read more)

Ky. Citizen Doctor of the Year nominations being accepted

The Kentucky Academy of Family Physicians is accepting nominations for Kentucky's Citizen Doctor of the Year award. Patients are encouraged to send in their recommendations by Feb. 1.

The award honors an outstanding, community-minded family physician who provides compassionate, comprehensive care. Candidates should be role models of their profession and of their communities. They must also be members of the academy.

Kentuckians wishing to nominate should send a letter (two-page maximum) that includes the nominee's name, office address and phone number and reasons why the nominee has earned the award to: Kentucky Citizen Doctor of the Year, c/o KAFP, PO Box 1444, Ashland KY 41105-1444. They should also include their own contact information, including email. For more information about the academy, click here.

St. Joseph Health System announces merger with Jewish Hospital & St. Mary's HealthCare

Rebuffed in its bid to take over Louisville's University Hospital, Catholic Health Initatives announced today that its St. Joseph Health System had merged with Jewish Hospital & St. Mary’s HealthCare, effective retroactively to Jan. 1. Gov. Steve Beshear rejected the original merger plan because of University Hospital's public status and the proposed control of CHI, which follows Catholic health directives.

The new organization is called KentuckyOne Health and is headed by Ruth W. Brinkley, as president and chief executive officer. She is a former executive at CHI and Ascension Health. The organization "includes hospitals, clinics, specialty institutes, home health agencies, satellite primary care centers, and physician groups with more than 80 locations, 2,500 staff physicians and more than 13,000 employees across the state of Kentucky and southern Indiana," CHI said in a press release. It said it will invest $320 million into the merger.

"As part of KentuckyOne Health, historically Jewish facilities will remain Jewish," the release said. "Historically Catholic facilities will remain Catholic." Dr. Gerald Temes, chair of Jewish Hospital HealthCare Services, said in the release, “We have had a mutually beneficial relationship with Catholic Health Initiatives for the last six years. We’re confident this is the right direction for the Jewish Hospital organization.” (Read more)

Device lets diabetics get blood-sugar levels using Web, iPhone

Starting next week, diabetics will be able to test their blood-sugar levels using a device that instantly sends their readings to an online database that can be accessed by the patient, doctor or caregiver. “This system charts the results to highlight trends and spot problems, and can be accessed via a Web browser or an iPhone app,” writes Walt Mossberg in a column in The Wall Street Journal.

With 366,000 adults in Kentucky already diagnosed with diabetes, the technology could signal a big change in diabetic care and could be a boon for diabetics living in rural areas.

Mossberg, a Type 2 diabetic, used the new device, made by Maryland-based Telcare, and assessed it uses. Looking like a “thick, old cellphone,” it works like a traditional meter, requiring the user to prick their finger to get a drop of blood and touch a test strip to it. That information is then sent to an online database. “Because it automatically logs results and allows real-time sharing, I believe diabetics who use this new system will be less likely to skip readings, or to fudge the numbers, especially if they allow doctors and other caregivers to see the results instantly. And that could mean an improvement in their health,” he writes.

Hospital employees report only 1 of 7 medical errors, study finds

In keeping with other studies on the subject, a new report shows hospital employees only report and recognize one out of every seven medical errors, accidents or other events that harm Medicare patients. "Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the 'adverse events'," reports Robert Pear of The New York Times.

While hospitals serving Medicare patients are supposed to track and analyze the cause of medical errors and most hospitals do have a system in place to inform administrators about adverse events, "Hospital staff did not report most events that harmed Medicare beneficiaries," said Daniel R. Levinson, inspector general of the Department of Health and Human Services and author of the report.

Levinson said more than 130,000 beneficiaries were subject to one or more adverse events in hospitals in one month. An adverse event includes medical errors, severe bedsores, hospital-acquired infections, delirium as a result from too many painkillers, or excessive bleeding because blood thinners were used improperly.

The study involved the input of independent doctors, who reviewed 293 cases in which patients had been harmed. Forty of the cases were reported to hospital managers and 28 were investigated by hospitals, "but only five led to changes in policies or practices," Pear reports.

One of the major issues is that hospital employees don't recognize when a patient is harmed, Levinson said. In some incidents, "employees assumed someone else would report the episode, or they thought it was so common that it did not need to be reported," Pear reports. In other cases, employees thought an event was so unusual it wouldn't be likely to recur.

In answer, Medicare officials said they will come up with a list of "reportable events" for hospitals and employees to use. Hospitals, in turn, should give detailed instructions to employees about what kinds of events should be reported. (Read more)