• Reflex: August 30, 2011

    Is health reform like the civil rights movement? That’s what Jay Angoff, special adviser to HHS Secretary Kathleen Sebelius, suggested, reports Lachlan Markay (Politico). Austin’s comment: Though Angoff  was referring to the degree of opposition from some governors, another potential parallel centers on whether health, like civil rights, is a merit good.

    Federal health care fraud prosecutions on the rise, reports Kelly Kennedy (USA Today). “New government statistics show federal health care fraud prosecutions in the first eight months of 2011 are on pace to rise 85% over last year due in large part to ramped-up enforcement efforts under the Obama administration.” Austin’s comment: Health care fraud is typically viewed through a crime-and-punishment lens. Another view is that it is a manifestation of the battle for and tension between quality and cost control

    Weekend and night outcomes in a statewide trauma system. A manuscript in the Archives of Surgery finds that patients presenting on weeknights were no more likely to die than patients presenting during weekdays, and patients presenting on weekends were less likely to die than patients presenting on weekdays. Aaron’s Comment: This flies in the face of everything many physicians secretly believe. You’d think patients presenting on weekends, when hospitals are less staffed, might suffer, but the opposite was true. Presenting at night was also no worse than presenting during the day.  Someone is bound to ask why we need all those extra personnel on the weekdays.

    (H/t, Igor Volsky)

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    • The Archives of Surgery report makes sense to me. On weekends, we are more likely to have people available to work exclusively on the trauma case right away. The blood bank isnt usually swamped with other work. A trauma service will still need a lot more people working on weekdays since that is when they bring back all of their patients for second look laps and washouts. They tend to spend much more time operating during the day. That is also when they do most of their critical care work.

      Steve