Health systems that employed fewer primary care physicians, have higher bed counts or are investor owned were more likely to provide more unnecessary or low-value care, a study published Jan. 14 in JAMAfound.
For the study, researchers from Baltimore-based Johns Hopkins University analyzed Medicare claims data at 3,745 hospitals for 17 low-value services. The low-value services were previously identified as unnecessary and included services such as pap smears for women older than 65, an abdominal CT scan with and without contrast and spinal fusions for back pain, according to the study.
The researchers then rated the hospitals using an overuse index, which was based on the Medicare claims for the low-value healthcare services. Health systems rated at least 1.5 standard deviations or more above the average in the overuse index were considered over-users of low-value services.
Below is a breakdown of the 20 hospitals that provided the most unnecessary care based on the overuse index.
1. St. Dominic Health Services (Jackson, Miss.)
2. USMD Health System (Irving, Texas)
3. Community Medical Centers (Clovis, Calif.)
4. Care New England Health System (Providence, R.I.)
5. East Alabama Medical Center (Opelika)
6. Pocono Health System (East Stroudsburg, Pa.)
7. University Health Care System (Augusta, Ga.)
8. Deaconess Health System (Evansville, Ind.)
9. Congregation of the Sisters of St Joseph of Peace (Englewood Cliffs, N.J.)
10. Iredell Health System (Statesville, N.C.)
11. Sacred Heart HealthCare System (Allentown, Pa.)
12. Southeast Health (Dothan, Ala.)
13. Chesapeake (Va.) Regional Medical Center
14. Butler (Pa.) Health System
15. CarolinaEast Health System (New Bern, N.C.)
16. Ohio Valley Health Services and Education Corp. (Wheeling, W.Va.)
17. Slidell (La.) Memorial Hospital
18. Lakeland (Fla.) Regional Health System
19. North Kansas City (Mo.) Hospital
20. Temple University Health System (Philadelphia)
COVID-19 hospitalizations are at record high numbers nationwide, though some parts of the country are seeing cases plateau or fall, Surgeon General Vivek Murthy, MD, said Jan. 16 on CNN‘s “State of the Union.”
In New York and other parts of the Northeast, “we are starting to see a plateau and, in some cases, an early decline in cases,” Dr. Murthy said. Daily average cases in New York have fallen 27 percent in the last 14 days, according to Jan. 18 data tracked by The New York Times. New Jersey, Maryland and Washington, D.C., have also seen cases fall in recent days.
“The omicron wave started later in other parts of the country. So we shouldn’t expect a national peak in the next coming days,” Dr. Murthy said. “The next few weeks will be tough.”
As of Jan. 17, a record 154,335 people were hospitalized with COVID-19 nationwide, HHS data shows. Hospitalizations had previously peaked at 142,273 on Jan. 14, 2021.
Two other forecasts to know:
1. Daily COVID-19 hospital admissions will increase over the next four weeks, with 17,900 to 48,000 new admissions likely reported on Feb. 4, according to ensemble forecasts the CDC published Jan. 12. For context, the current seven-day hospitalization average for Jan. 5-11 is 20,637, a 24.5 percent increase from the previous week’s average.
2. CDC forecasting predicts COVID-19 deaths will increase nationwide over the next month, with 10,400 to 31,000 deaths likely reported in the week ending Feb. 5. Current forecasts should be interpreted with caution, the CDC said, as they may not fully account for omicron’s rapid spread or changes in reporting during the holidays.
New daily COVID-19 hospitalization rates in the U.S. have risen 54 percent over the last two weeks, with all 50 states and the District of Columbia seeing hospitalization rates trend upward, according to data tracked byThe New York Times.
Data is taken from HHS and was last updated Jan. 18. States are listed in order of hospitalization rate percent increase over the last two weeks.
Alabama 14-day change: 133% increase Hospitalizations per 100,000 people: 50
Louisiana 14-day change: 120% increase Hospitalizations per 100,000 people: 41
California 14-day change: 118% increase Hospitalizations per 100,000 people: 35
Mississippi 14-day change: 109% increase Hospitalizations per 100,000 people: 47
Florida 14-day change: 105% increase Hospitalizations per 100,000 people: 53
Hawaii 14-day change: 102% increase Hospitalizations per 100,000 people: 25
South Carolina 14-day change: 102% increase Hospitalizations per 100,000 people: 43
Washington 14-day change: 99% increase Hospitalizations per 100,000 people: 31
Alaska 14-day change: 89% increase Hospitalizations per 100,000 people: 15
Texas 14-day change: 86% increase Hospitalizations per 100,000 people: 45
Arkansas 14-day change: 81% increase Hospitalizations per 100,000 people: 43
Nevada 14-day change: 81% increase Hospitalizations per 100,000 people: 57
Vermont 14-day change: 77% increase Hospitalizations per 100,000 people: 19
Massachusetts 14-day change: 76% increase Hospitalizations per 100,000 people: 46
Georgia 14-day change: 71% increase Hospitalizations per 100,000 people: 57
Tennessee 14-day change: 70% increase Hospitalizations per 100,000 people: 47
North Carolina 14-day change: 65% increase Hospitalizations per 100,000 people: 46
Oregon 14-day change: 64% increase Hospitalizations per 100,000 people: 21
Virginia 14-day change: 58% increase Hospitalizations per 100,000 people: 46
Rhode Island 14-day change: 57% increase Hospitalizations per 100,000 people: 51
Utah 14-day change: 57% increase Hospitalizations per 100,000 people: 22
Wyoming 14-day change: 57% increase Hospitalizations per 100,000 people: 18
Montana 14-day change: 52% increase Hospitalizations per 100,000 people: 20
Oklahoma 14-day change: 51% increase Hospitalizations per 100,000 people: 41
Idaho 14-day change: 50% increase Hospitalizations per 100,000 people: 22
South Dakota 14-day change: 46% increase Hospitalizations per 100,000 people: 39
Colorado 14-day change: 45% increase Hospitalizations per 100,000 people: 31
Connecticut 14-day change: 44% increase Hospitalizations per 100,000 people: 57
Missouri 14-day change: 44% increase Hospitalizations per 100,000 people: 61
New York State 14-day change: 40% increase Hospitalizations per 100,000 people: 67
Kentucky 14-day change: 39% increase Hospitalizations per 100,000 people: 51
New Jersey 14-day change: 39% increase Hospitalizations per 100,000 people: 69
District of Columbia 14-day change: 37% increase Hospitalizations per 100,000 people: 125
Kansas 14-day change: 37% increase Hospitalizations per 100,000 people: 43
West Virginia 14-day change: 35% increase Hospitalizations per 100,000 people: 52
Pennsylvania 14-day change: 34% increase Hospitalizations per 100,000 people: 63
Arizona 14-day change: 33% increase Hospitalizations per 100,000 people: 44
Maryland 14-day change: 32% increase Hospitalizations per 100,000 people: 60
Wisconsin 14-day change: 32% increase Hospitalizations per 100,000 people: 43
Maine 14-day change: 28% increase Hospitalizations per 100,000 people: 34
Nebraska 14-day change: 28% increase Hospitalizations per 100,000 people: 35
Iowa 14-day change: 24% increase Hospitalizations per 100,000 people: 31
Illinois 14-day change: 21% increase Hospitalizations per 100,000 people: 56
Delaware 14-day change: 20% increase Hospitalizations per 100,000 people: 64
Minnesota 14-day change: 20% increase Hospitalizations per 100,000 people: 31
New Mexico 14-day change: 19% increase Hospitalizations per 100,000 people: 31
North Dakota 14-day change: 19% increase Hospitalizations per 100,000 people: 34
Michigan 14-day change: 17% increase Hospitalizations per 100,000 people: 48
New Hampshire 14-day change: 14% increase Hospitalizations per 100,000 people: 33
Ohio 14-day change: 13% increase Hospitalizations per 100,000 people: 59
Indiana 14-day change: 8% increase Hospitalizations per 100,000 people: 49
Access to healthcare in childhood has long term effects on health outcomes, but many children in the US are either uninsured or underinsured, meaning they often don’t have access to the care they need. Why is that and what can we do about it?
The Omicron variant doesn’t cause as much severe illness as other variants have, but its “mild” symptoms can still be pretty unpleasant.
The big picture: The way health care professionals and doctors differentiate between “mild” and “severe” illness may not align with a layperson’s understanding of those terms.
“To a health care professional, ‘mild’ means you’re not getting hospitalized,” said Megan Ranney, academic dean at the Brown University School of Public Health.
But, she said: “Omicron symptoms can range from absolutely no symptoms to a really mild cold to something where you are in bed with shakes and chills, and have a horrible cough and are fatigued and headachy for weeks. Those are all ‘mild.'”
A “severe,” illness means you’d likely have symptoms such as very low oxygen levels, kidney damage and heart impairment, she said.
What we’re watching: Omicron is causing a lot less severe illness than previous variants, but a “mild” case can still require about a week away from work, especially in front-line jobs.
And because so many people have gotten infected in such a short time, it’s leaving schools, airlines, and other businesses — including, critically, hospitals — with large numbers of workers out sick simultaneously, The Atlantic reported.
Then there’s the matter of long COVID. A study published Thursday in Nature Immunology found ongoing, sustained inflammatory responses following even mild-to-moderate COVID-19 cases.
What they’re saying: “It’s going to be a messy few weeks. I don’t think there’s any way around it,” said Joseph Allen, a professor of public health at Harvard, per The Atlantic.
HENRY KOTULA 