Entries in JAMA (2)


Study: More Trauma Patients Surviving Hospital Stay

Thomas Northcut/Thinkstock(SEATTLE) -- The quality of care received by injured patients on the scene and in hospital trauma centers plays an important role in their ability to leave the hospital alive. A new study of trauma patients finds that many more are surviving their hospital stay, however, survival rates at three years for these patients are lower than expected. 

An ambulance is often the quickest way to transport an injured patient to the hospital for treatment. Once inside a trauma center, that treatment is critical to their overall survival.

Researchers in Washington state found patients who die from their injuries while in the hospital decreased from eight percent in 1995 to about five percent in 2008. "That's the good news. So many more patients survive the hospital stay and get discharged," says Dr. Sam Arbabi from Harborview Medical Center, in Seattle and co-author of the study. He then wanted to know where these patients go after leaving the hospital and what their long-term survival rates are. Researchers analyzed statewide trauma records that were linked to death certificate data over a period of 14 years. "Overall trauma patients have a higher likelihood to die even if they survive their injury in the hospital compared to non-trauma patients," according to Dr. Arbabi. 

The study appears in this week's Journal of the American Medical Association

After hospitalization for trauma, about half the patients go home, the rest are admitted to rehabilitation or skilled nursing facilities.  "Patients that get discharged to skilled nursing facilities as opposed to patients that get discharged to rehab centers or patients that get discharged home have higher risk of death in one year and three years," according to Arbabi.  Researchers do emphasize that patients released to skilled nursing facilities are often older and lower functioning than those who go elsewhere. "It doesn't suggest that skilled nursing facility is the cause, it's an association but it does suggest that there is an area that we can improve outcomes," Arbabi points out.

Researchers say the next step would be compiling outcome data from skilled nursing facilities like hospitals provide to look at ways of increasing survival rates at those facilities.

Copyright 2011 ABC News Radio


Study: Black Patients More Likely Than White Patients to Be Re-Admitted

Photo Courtesy - Getty Images(CHICAGO) -- Eliminating the racial gaps in U.S. health care remains a national priority.  One of those gaps involves hospital readmission rates. A new study finds black patients within the Medicare system are more likely than white patients to be readmitted within 30 days of a hospital visit for three common conditions, with differences related to race and where the care was received.

Heart problems or an episode of pneumonia are some of the most common conditions bringing the elderly into America's hospitals, but what happens to many of these patients in the first 30 days after they go home? "It's a time in which patients are very vulnerable to developing a complication that might end up with them coming back into the hospital," says Dr. Karen Joynt from Harvard's Brigham and Women's Hospital.

She along with co-authors analyzed data involving more than three million Medicare patients, admitted to hospitals nationwide from 2006 to 2008 for heart attack, heart failure and pneumonia. Researchers looked at how many of these patients were readmitted to the hospital during the first 30 days after being discharged. "Black patients overall had a 13 percent higher odds of readmission than white patients across all three conditions," according to Joynt. The study appears in this week's Journal of the American Medical Association. "Patients discharged from hospitals that served a high proportion of black patients had about a 25 percent higher odds of readmissions."

Researchers say understanding why black patients are readmitted to the hospital more often than white patients may help improve the quality of care they receive. "It's a time in which patients often have to adjust to new medications, new physicians sometimes, new follow up plans, new nutrition plans and that's a time where we're really seeing a disparity between patients who may have more resources to support them once they come out of the hospital," Joynt says. Involving family whenever possible may also help in improving patient outcomes. 

Researchers say this study is one of the first nationwide looking at how the  most common medical conditions are affecting Medicare patients.

Copyright 2011 ABC News Radio

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