HealthSTAT

From the Atlanta Journal-Constitution:

Grady Memorial Hospital said this week it had negotiated a rough agreement with local dialysis clinics to provide care to 38 uninsured immigrants once served by Grady.

While the agreement eased concerns for those patients, most of them illegal immigrants, it does not address the dilemma of the future: What happens to the next wave of uninsured patients facing kidney failure?

Grady closed its outpatient dialysis unit in October to help it balance its books. The hospital said the unit was losing $4 million a year serving about 100 patients.

Most Americans with end-stage renal disease are covered by Medicare. Illegal immigrants, and some legal immigrants new to the country, are not eligible for the program.

A deal brokered yesterday between Grady Memorial Hospital and local dialysis providers will likely allow the patients displaced by the closing of Grady’s outpatient dialysis clinic last year continue to receive treatment. However, the underlying problem of paying for dialysis care for patients who are not eligible for Medicare remains unsolved.

See today's press release about HealthSTAT's involvement in the statewide Partner Up! public health campaign.  Currently, we are looking to engage public health students in lunchtime talks to educate their interdisciplinary peers on public health and how it's approached here in Georgia.  Contact Michelle at michelle@healthstatgeorgia if you'd like to be a part of this statewide initiative!

Advisory board guides Georgia public health campaign

Atlanta – August 31, 2010 – A 31-member advisory board, which includes representatives of many of Georgia’s best-known community, education and health organizations, is guiding a campaign aimed at educating policy makers and the public about the need to reinvest in and rebuild the state’s public health system.

Several advocacy groups have continued to work on ensuring dialysis patients keep receiving life-saving care they need. Last year, Grady was forced to close its dialysis center due to financial constraints. This action left 40 undocumented patients without dialysis care.  Below, read a release from the Grady Coalition Advocates:

40 undocumented dialysis patients have received word from Grady hospital that they would be responsible for finding their own dialysis care after August 31st. Grady had been paying a private dialysis provider called Fresenius to provide dialysis care to the patients up to this point.

Julie Rovner, in her latest installment for NPR on doctor shortages, looks at how physician assistants and nurses are providing the bulk of care at some clinics, especially in rural areas.  

Read the article here. 

One of the first measures of the Affordable Care Act to roll out was the requirement for restaurants to post calorie counts for items on their menus. The FDA, however, wants to take it one step further, requiring other institutions, such as movie theaters and airplanes, to offer calorie counts. Although nutrition advocates applaud the move, industry is heavily against it.

Drs. William T. Branch, Minesh Shah, and Jada Bussey-Jones discuss our primary care system and tough choices students must face when deciding to go into primary care.  Although primary care can help maintain and prevent most chronic conditions, the incentives to practice are quite few.  

Read the opinion piece in today's AJC and keep the dialogue going through comments!

Unlike some other states, Georgia lacks a coordinated statewide trauma system to help distribute patients to the appropriate facility. That leaves physicians to shop patients around themselves.

In 2007, Newsweek magazine described a typical Saturday night in Grady Memorial Hospital’s emergency room, the only Level I trauma center within 120 miles of Atlanta, as overwhelmed doctors and nurses struggled to treat patients brought in from across the state with life-threatening injuries:

Doctors and nurses darted from one patient to another, medicating, bandaging and intubating them. Amid the tumult, one nurse exclaimed: "This is Lebanon! This is Afghanistan!" The neurosurgery team was overwhelmed. One resident drilled a hole into the female gunshot victim's skull, so he could insert a tube that would relieve the pressure on her brain. Another resident re-bandaged the other gunshot victim's head, which oozed blood and brain matter all over the sheets. Why all the head injuries? It turned out that most hospitals in the area at that hour had either no Intensive Care Unit beds or no neurosurgeons available…

Though emergency room crowding is often blamed on uninsured patients who are unable to access care elsewhere, a recent survey found that uninsured Americans were no more likely to visit an emergency room than those with health insurance. The results of the survey – one out of every five people visited an emergency room in 2007 – underscore the importance of insuring that emergency medical services are available, even though they are rarely profitable for hospitals.

As Georgia prepares for a November referendum on a $10 vehicle registration fee to fund trauma care, some have suggested that the money raised would only end up subsidizing care for the uninsured. This survey clearly refutes that argument. The types of illnesses and injuries that can send someone to an emergency room do not choose their victims based on whether or not they have health insurance.

By Benjamin Nanes

This November, Georgians will vote on adding a $10 fee to vehicle registrations, to be directed toward trauma care. Or is it a tax? If you listen to the pundits and politicians, the fee versus tax debate defines the referendum. But they’re wrong; nothing could be less relevant. Georgia needs dedicated funding for a trauma care system that will save lives and help the state’s economy, not a petty debate over what constitutes a “fee” or a “tax.” The question is simple. Is it worth $10 to save a life? The answer should be simple too.