Scoring hospitals by billing quality

Using data collected by Johns Hopkins University, Michelle McGhee and Will Chase for Axios provide a visual reference for the billing practices of for-profit hospitals:

Rising deductibles and out-of-pocket costs are increasingly leaving patients responsible for bloated medical bills. A new analysis by Johns Hopkins University reveals that many of the top 100 hospitals by revenue in the U.S. use predatory tactics to pursue patients with unpaid bills.

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Where ICUs are near capacity

The New York Times mapped the seven-day average of ICU bed occupancy rates:

More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the Covid-19 epidemic.

Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services.


It only took HHS many months into a pandemic to release the facility-level dataset.

You can download the data here.

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Where there are hospital staff shortages

Reporting for NPR, Sean McMinn and Selena Simmons-Duffins on staffing shortages:

On data availability:

This is the first time the federal agency has released this data, which includes limited reports going back to summer. The federal government consistently started collecting this data in July. After months of steadily trending upward, the number of hospitals reporting shortages crossed 1,000 this month and has stayed above since.

The data, however, are still incomplete. Not all hospitals that report daily status COVID-19 updates to HHS are reporting their staffing situations, so it’s impossible to tell for sure how much these numbers have increased.

The first time.

It was back in March, a few lifetimes ago, when we were talking about flattening the curve so that hospitals could provide care to those who needed it. This federal dataset is just coming out now in November? Obscene.

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Hospital bed occupancy

Using estimates from the Harvard Global Health Institute, The Upshot mapped what hospital bed occupancy might look like across the country if we don’t make changes now:

“If we don’t make substantial changes, both in spreading the disease over time and expanding capacity, we’re going to run out of hospital beds,” said Dr. Ashish Jha, the director of the Harvard Global Health Institute, which produced the estimates. “And in that instance, we will not be able to take care of critically ill people, and people will die.”

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Think it’s a stroke? 4 reasons it’s better to call 9-1-1 than drive yourself to the hospital


Posted May 22, 2017 by Lieutenant Commander Erika Odom, Ph.D., M.S., United States Public Health Service

Stroke—also called a “brain attack”—can happen to anyone at any time. On average one American dies from stroke every 4 minutes. Most strokes happen when blood flow to the brain is blocked, causing brain cells to die. Stroke is the fifth leading cause of death in the United States and a major cause of long-term disability.

Your best chance for surviving a stroke and having a full recovery is getting to the hospital quickly. But did you know that 1 in 3 stroke patients doesn’t call an ambulance? Instead, they may not recognize they’re having a stroke, try to wait to see if their symptoms go away, or may try to drive themselves or have another person drive them to the emergency room. All of these things actually increases your risk for disability and death.

Learn why it’s always best to call 9-1-1 if you think that someone is having a stroke.

    1. EMS gets you to the hospital faster. You may think that you’ll get to the hospital faster if you drive yourself or have a loved one drive you during a stroke. But the truth is, the EMS professionals on board may be able to start your treatment right away. Think of calling 9-1-1 as bringing emergency room resources to your door. Ambulance drivers also have the right of way when they use lights and sirens.
    2. EMS saves precious time once you reach the hospital. You are more likely to be treated quicker at the hospital when you arrive by ambulance. This is because, on the way to the hospital, EMS professionals begin your treatment by:
      • Screening you for stroke symptoms.
      • Monitoring your heart rate and blood pressure.
      • Getting information about any medicines you take, your medical history, or other important information a medical team needs to know.
      • Calling ahead to the hospital to let the medical team know a stroke patient is arriving. This gives the hospital team time to prepare equipment and medicines that you may need.
    3. Every Minute CountsYou can get an important drug to treat stroke if you call 9-1-1. When it comes to stroke, time lost is brain lost. Every minute a stroke goes untreated, a patient loses nearly 2 million brain cells. Because stroke is often caused by a blood clot, a clot-busting drug such as alteplase is an effective treatment if you get to the hospital in time. But clot-busting drugs can only be given to patients within 3 hours of a stroke. EMS professionals responding to a 9-1-1 call about stroke will ask the patient and any bystanders questions about when the symptoms started, giving the medical team critical information about whether the patient can be treated with the clot-busting drug. At the hospital, you are also more likely to get alteplase if you arrive by ambulance. Many stroke patients who need the drug don’t get it, because they wait too long to call 9-1-1 or get to the hospital too late for treatment.
    4. EMS can get you to a hospital that specializes in stroke treatment. When stroke happens, getting to any hospital is important. But some hospitals are better equipped than others to treat stroke patients. Hospitals that specialize in stroke, like certified stroke centers, have developed standards of care for stroke patients and may have more staff, medicine, and equipment for treating stroke on hand. There are more than 1,000 certified stroke centers nationwide. Find a stroke center near you.

Stroke happens to nearly 800,000 Americans a year. Don’t hesitate to call 9-1-1 right away if you suspect a stroke is happening to you or someone else because that is the best chance at survival, treatment, and recovery.

May 21–27 is National Emergency Medical Services (EMS) Week. Learn how CDC’s Coverdell Program works with EMS professionals and state organizations to improve stroke care and save lives.

Posted May 22, 2017 by Lieutenant Commander Erika Odom, Ph.D., M.S., United States Public Health Service

Did a late night TV host just change the US debate about universal health care and medical research?

0000-0002-8715-2896“I have a story to tell about something that happened to our family last week.” With those words, Jimmy Kimmel opened his show. Using a combination of vulnerability and humour, he told us about the

The Narrative of Privilege

Today we welcome Luckett to the blog. Her biography is at the end of the post. ‘Miss,’ she said, as I bit my tongue. I was choking on the worst insult a female junior doctor can bear, ‘I know that crystal … Continue reading »

The post The Narrative of Privilege appeared first on PLOS Blogs Network.

Listen: Dr. Christopher Labos and I on the Rise of Integrative Medicine

This month, Within Reason tackles a scientific topic, so I can publicize it here! Woohoo!

Would you like a side of magic with your chemo? Disproven folk remedies used to be the domain of snake oil salesmen; now, they are being integrated into university health centres. Jonathan speaks to Dr. Christopher Labos, a public science educator and cardiologist, on this worrying trend. Where is the line between feel-goodery and wishful thinking? The recent case of Makayla Sault highlights the harm caused by magic’s new veneer of respectability. Back in the studio, Andrew Cody returns to the podcast, flanked by Anna af Hallstrom, to discuss laundry balls, foot detox, and child abuse. Are our panelists hopeful for the future of science-based medicine?

You can listen to the podcast (for free) at

If you prefer iTunes, search for “Within Reason” and look under “Podcasts”!

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Rare enterovirus in US children: what’s going on?

Recently, a mild-to-severe respiratory illness in children in the Southeast and Midwest United States has been emerging. The US Centers for Disease Control and Prevention (CDC) report that between mid-August and September 11th, 2014, their laboratory has confirmed

The post Rare enterovirus in US children: what’s going on? appeared first on PLOS Blogs Network.

Listen: A Patient Cracking the Case of Evidence-Based Medicine

Another great episode of the CBC radio show White Coat Black Art with @NightShiftMD.

Beth Daley Ullem, former case cracker at McKinsey & Company, remembers how she shopped for the right hospital to take care of her unborn son. Absolutely fascinating.

All patients should have access to the data that Beth had, but that’s unfortunately not the case.

Listen to the podcast here.