Kentucky hospitals score mostly Bs and Cs on hospital safety scorecard; most in U.S. earned an A or B

In an analysis of the nation's hospitals and their safety records, many of Kentucky's health care facilities have some shortcomings. A study by the Leapfrog Group finds that the vast majority of the state's hospitals score a B or C in overall patient safety, a term defined here by analysis of data on accidents, errors and infections as kept by the Centers for Disease Control, the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research. At least a dozen of the state's hospital earned an A rating. To check the grade of your own hospital, go here.

In this data analysis and grading system, 26 different points of criteria were used. Of the 2,618 hospitals reviewed, about 56 percent of the hospitals earned an A or B, and an additional 38 percent passed with a C grade. Only 6 percent of hospitals -- 146 total -- received a D or F. According to CBS News, at least 180,000 Americans die in hospitals every year from incidents that occur because of their stays there. (Read more)

Task force recommends changes to protect safety and health of middle school students who play interscholastic sports

The boys of North Marshall Middle
School of Benton, Ky., after winning
a Christmas tournament last year.

Beth Musgrave of the Lexington Herald-Leader reports that the state Task Force on Interscholastic Athletics at the Middle School Level announced its preliminary recommendations this week to address concerns about young athletes' health and safety. It seems that middle school sports in Kentucky have never had the advantage of being governed by a unified code of rules and policies like their counterpart in high school sports. This has led to a confusing mish-mash of guidelines that the legislature is setting out to get right in the coming year.

Preliminary task force recommendations include requiring all middle school teams to follow high school rules on physical exams, medical coverage, concussions and practicing during extreme heat, and requiring the tracking of injuries and incidents for all sports. The task force also suggested that the Kentucky Board of Education look to create a single governing body, like the Kentucky High School Athletics Association that governs high school sports, to oversee all middle-school sports. Wilson Sears, executive director of the Kentucky Association of School Superintendents and a task force member, told Musgrave that the recommendations represent "real progress." (Read more)

The world is getting fatter, but Kentucky's rate of obesity is two and a half times the world rate

Take no solace from The Economist, which proclaims in its yearly analysis-and-prognostication issue that this is the year world leaders will take on worldwide obesity because, writes Charlotte Howard, "they will realize something must be done."

So, no, it is not just you, Kentucky. In fact, Howard, the health-care correspondent for the magazine, writes that 30 percent of Mexico's adult population is obese. That is precisely the same percentage of Kentuckians that were considered obese by a Robert Wood Johnson Foundation and Trust for America's Health analysis released in August. (We ranked sixth fattest state nationwide.) It is also the same percentage of Chinese adults that are, as Howard put it, "too wide" -- a term that Howard uses here to include the overweight as well as the obese.

But there is no room to crow here. Kentucky is far ahead of the trend. Only 12 percent of the world counts as obese today. We beat that two and half times over. (The number of Kentuckians who were merely overweight was not calculated or included in the figures in the study.) A study released in September by the same group found that if trends continue, 60 percent of Kentuckians will be obese by 2030. The World Health Organization's estimate of the world's obesity was at 15 percent by 2020.

The Economist folks favors an approach that a democratic path to better health and fiscal sanity, given the health care cost ramifications of obesity. They like a tax on soda -- it's pure sugar, no real nutrition. They like subsidies to make fresh produce cheaper. And they like better school lunches and labeling, labeling, labeling so consumers will make better choices.

UK study: Old, perhaps obsolete heart drug increases deaths in patients with atrial fibrillation

A drug widely used against heart disease can increase the possibility of death when used by patients with atrial fibrillation, a common heart rhythm problem, according to a study by University of Kentucky researchers. Digoxin, a derivative of the foxglove plant, is an old yet controversial heart drug. Though considered obsolete by some, it is still widely used.

The study, published in European Heart Journal, analyzed data from 4,060 atrial-fibrillation patients. It was led by Dr. Samy Claude Elayi, associate professor of medicine at UK HealthCare's Gill Heart Institute. The results of the study indicate that further review by the Food and Drug Administration is warranted to determine if stronger warnings about its use should be required. (Read more)

N. Ky. Chamber to ask state for more funding to fight heroin; London police make first known heroin trafficking arrests there

The Northern Kentucky Chamber of Commerce is planning to lobby the state for more funding for heroin treatment after receiving reports from business and law enforcement about the breadth and depth of the drug problem in the region. Terry DeMio of the Cincinnati Enquirer reports that the chamber's Geraldyn Isler says the area has the “highest volume of people in the state needing substance abuse treatment but is receiving the least amount of funding.”

According to the Northern Kentucky Drug Strike Force, 63 percent of heroin possession and trafficking prosecutions in Kentucky are in Boone, Kenton and Campbell counties, the three urbanized counties in the region. A 2007 University of Kentucky study that shows that the region led the commonwealth in people needing substance abuse treatment, but that it also received the lowest per capita funding from staff coffers for those mental health services for more than a decade.

The chamber told DeMio there are many "hidden costs" to such abuse. Among those costs: increased employee absenteeism, tardiness, job-related injuries and errors. It also notes employee-employer conflict, greater health-insurance costs and crime as likely outcomes of heroin in the region.  (Read more)

There could be other requests for more funding for heroin treatment. This week the London Police Department made the first known arrests for heroin trafficking in Laurel County, The Sentinel-Echo reports.

Two Kentucky moms participate in Duke study that found potentially toxic and unnecessary chemicals in most couches

Two Central Kentucky mothers participated in a Duke University-led study published today that shows that a vast majority of U.S. couches contain potentially toxic flame retardants that pose risks to humans. Wendy Koch of USA Today reports that the risks occur when the chemicals migrate from furniture foam into house dust.

The closely watched study revealed that more than 40 percent of the foam in the 102 couches tested contained the carcinogen chlorinated Tris, a substance that was ordered removed from children's pajamas 35 years ago. Another 17 percent of the couches contained pentaBDE, a globally banned substance. More than 85 percent were treated with a potentially toxic flame retardant, which researchers and experts say amounted to more than a pound of chemicals per couch. Flame retardants have been linked to hormone disruption, cancer and neurological toxicity in hundreds of animal and human studies. A fire specialist told Koch that the chemicals are not effective in suppressing fires.

The two Kentuckians, both women concerned about their family's health, sent samples from their couches to be analyzed and both expressed horror at the findings. Dr. David A. Atwood, a chemist at the University of Kentucky, said a systematic shift in chemical regulation is necessary to protect public health. “We have made an enormous mistake assuming that a chemical should be used freely until it is determined to have adverse health effects, rather than taking the position that all chemicals should be avoided unless it is absolutely certain that the chemical is safe." In New York, legislation is already in motion that would ban chlorinated Tris. According to the Kentucky Environmental Foundation, efforts will begin next year to restrict the toxic chemical. (Read more)

Experimental concentrated breast cancer radiation therapy offers new options for women who live far away from treatment facilities

A study at the University of Louisville James Graham Brown Cancer Center designed to make  radiation treatment more accessible to women who face obstacles such as distance, transportation problems and time constraints is proving promising. The idea is to cut daily trips to the cancer center to once a week, says Dr. Anthony Dragon, a radiation oncologist at U of L. It also has the added benefit of cutting treatment costs by better than half.

Laura Ungar of The Courier-Journal in Louisville reports that Dragun led a previous study that found that "about a third of Kentucky women with early-stage breast cancer didn’t get recommended radiation treatments after lumpectomy surgery. Among those least likely to get radiation were rural Kentuckians, the elderly, African Americans and women in the Appalachian region of the state. Women who did not get recommended radiation were 60 percent more likely to die during the time they were studied."

Dragun told Ungar that the folks at U of L were not satisfied with just gathering those numbers, they wanted solutions to the problem. Dragun said the new experimental regimen is yielding good results, with women who get weekly radiation reporting similar levels of side effects as those getting radiation every day. Ungar notes that some outside experts say the approach does seems promising, but one critic was concerned about breast appearance results after the once-a-week treatments.

According the National Cancer Institute, more than 3,070 new cases of breast cancer were diagnosed in Kentucky in 2009 and was responsible for 614 deaths.  (Read more) 

Report: Bounce-house injuries to children have skyrocketed

A new report out today in the journal Pediatrics warns that, on average, 31 children a day are transported to U.S. emergency departments for treatment of bounce-house injuries, including fractured bones and muscle damage. "If this was an infectious disease, we'd call it an epidemic and it would be on the front pages all over the country," said study co-author Dr. Gary A. Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. (Associated Press photo)

Randy Dotinga of HealthDay reports that in the 15-year period between 1995 and 2010, the rate of bounce-house injuries jumped 15-fold, with the number escalating in the last few years of the study. In the new study, published online Monday and in the December print issue of Pediatrics, researchers found the most common bounce-house injuries were fractures, strains and sprains. Concussions and cuts were more common in boys. The average age of those hurt was 7.5 years old. (Read more) 

Expanding Medicaid in Kentucky would add 5 percent to the state's cost over the next 10 years, national study predicts

Expanding Medicaid to people making up to 138 percent of the poverty level under federal health reform and its heavy subsidies would cost Kentucky about 5 percent more for Medicaid over the next 10 years than doing nothing, the Kaiser Family Foundation said in a state-by-state analysis today.

According to the study done by the Urban Institute for the foundation's Commission on Medicaid and the Uninsured, the state would spend $25.1 billion from 2013 to 2022 if it and no other state expanded the program. If all states expanded it, Kentucky's cost would be $26.4 billion, the study estimated.

Under the Patient Protection and Affordable Care Act, the federal government would pays the full cost of the expansion from 2014 to 2016. The federal government’s share would drop to 95 percent in 2017 and to 90 percent by 2020. In the 2013-14 fiscal year, the state budget calls for $1.48 billion in state funds to be spent on Medicaid benefits. The federal government pays about 72 percent of the program's cost in Kentucky.

In human terms, the report says the law will reduce the number of people in Kentucky without health insurance in 2022, no matter what happens. It says that if the act had never passed, 740,000 Kentuckians would have been uninsured in 2022. It will reduce that number to 513,000 even if Medicaid is not expanded anywhere. If all states expand Medicaid, the number of uninsured Kentuckians would drop to 332,000, the study estimates.

The Kaiser report is an update of a study done before the U.S. Supreme Court ruling ruled that the law was constitutional but made Medicaid expansion optional for states. So far, eight states have indicated their unwillingness to participate in the expansion, though more are expected to opt out but are waiting until legislatures return in January to discuss the matter.

See the entire report here.

Judge rules University of Louisville's hospital is public and subject to Open Records Act; it may appeal

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

Christian Co. Health Dept. to stop providing cancer screens, contraceptives to residents of other counties

As of Jan. 1, the Christian County Health Department will not provide contraceptives or cancer screening to indigent patients if they do not reside in the county. Nick Tabor of the Kentucky New Era reports the department will provide those services to other counties' residents if the county in which they reside has signed a contract with Christian County before the Jan. 1 deadline agreeing to repay Christian County for those services. Tabor writes that the policy is not applicable to those services that are covered by state or federal government reimbursements.

The health department's move was prompted by a budget deficit that is close to $200,000, some of it traceable to a lack of reimbursement for contraceptive care. Mark Pyle, director of the department, told Tabor that residents of both Todd and Trigg counties often seek services in Christian County and Christian county taxpayers foot that bill. Pyle explained that there’s nothing in state law saying the health departments have to serve anyone who comes in, regardless of residence.

The New Era is behind a paywall. To obtain a subscription, go here.

UK, ARH planning efforts against high rate of heart-disease deaths and limited availability of proper food in Perry County

The death rate from heart disease is nearly twice as high in Perry County (Wikipedia map) as in Kentucky as a whole, so there's no better time than now to announce that the University of Kentucky Medical Center is close to finalizing a three-year agreement with Hazard Appalachian Regional Healthcare Medical Center to provide continuing care, outreach and education to local physicians and county residents, including more and better information about heart-healthy food choices. Bailey Richards of the Hazard Herald reports that this last task is daunting, particularly since availability of good food is an issue in remote parts of the county.

Richards writes that a 2011 study of the heart-healthy food options in Perry County "showed that the area severely lacks low-fat and low-sodium options." Kevin Luley, a registered nurse at the UK Medical Center and winner of the "Heart Health in Rural Kentucky" grant, surveyed all of the restaurants and grocery stores in Perry County and found that most do not have many off-the-shelf options for a healthy diet. Of all of the items available at the restaurants in Perry County, fewer than 6 percent were considered healthy. (Residents can consult their own smartphones for that information. It should also be posted or available upon request.) Of a standard list of produce items, on average only 60 percent were found at the local grocery stores, Luley found. (Read more)