State Ranks High In Opioid-Related Visits To Hospitals

In less than eight hours last June, Yale New Haven’s emergency department treated 12 patients who had overdosed on opioids. Three died; nine were saved. With opioids in wide circulation, Dr. Gail D’Onofrio, chief of emergency medicine at the hospital and chair of emergency medicine at Yale School of Medicine, isn’t sure that one-day spike will stand as a record. “To be honest, no, I don’t expect the numbers to get better,” D’Onofrio said. “We’re going to have more treatment options in Connecticut, I think, more safe prescribing — but I don’t know that we’ll see improvements in the numbers of people using.”

D’Onofrio’s concerns are borne out in a recent report by the Agency for Healthcare Research and Quality (AHRQ) that ranks Connecticut the 5th highest among 30 states in the rate of opioid-related emergency department (ED) visits — 254.6 per 100,000 population in 2014, well above national rate of 177.7.

Risk Of Death In Connecticut Linked To Where You Live

Connecticut has seen significant reductions in deaths from breast and colon cancer in the last three decades, but the state exceeds the national mortality rate for uterine cancer and three other cancers, as well as for mental health and substance use disorders. An analysis of data compiled by the Institute for Health Metrics and Evaluation at the University of Washington, published in JAMA, also shows wide disparities between Connecticut counties in death rates from certain cancers and other illnesses. Windham County had the highest mortality rates for seven of 10 cancers identified in the study as having the highest disease burden or responsiveness to screening and treatment, including pancreatic, uterine and lung cancer. Tolland County, meanwhile, had the lowest death rates for five cancers, including breast cancer, while Fairfield County was lowest for four. Similarly, deaths from chronic respiratory diseases in Windham County were nearly double the rate in Fairfield County – 63.13 per 100,000, compared to 34.15.

Pediatric Psychiatric Cases Continue Climbing, Swamping ERs

The state’s efforts to direct children in mental health crisis away from emergency rooms, to other services, have fallen short, with major hospitals reporting staggering increases in patient visits since 2013: Up 32 percent at Connecticut Children’s Medical Center, and 81 percent at Yale New Haven Hospital. The children’s hospital (CCMC) reported nearly 3,300 visits last year – 275 a month, on average — with the average length of stay increasing to 15 hours from less than 12 in 2013. “I wish I could say we had made a lot of progress, but we haven’t,” said Dr. Steve Rogers, medical director of the emergency department’s (ED’s) behavioral health unit. “Unfortunately, I think it’s only going to keep trending this way.”

Similarly, Yale saw ED visits by children ages 15 and younger rise from fewer than 750 in 2013 to more than 1,350 in 2016 — and the numbers are running even higher this year, said Dr. Claudia Moreno, medical director for psychiatric emergencies in Yale’s children’s emergency department. At times, she said, all ED beds are full, and children wait on hallway gurneys.

New Strain On State Nursing Homes: Keep Patients Out Of Hospitals

At the Fresh River Healthcare nursing home in East Windsor, the chance that a short-stay patient will end up back in the hospital within 30 days of arriving at the facility is less than eight percent. Meanwhile, 12 miles away at the Greensprings Healthcare and Rehabilitation nursing home in East Hartford, more than a third of patients who came from hospitals will be readmitted in 30 days. The wide swing in nursing home patients’ re-hospitalization rates has a lot to do with the condition patients are in when they are discharged from inpatient stays, as well as the planning that goes into the transition to other care. The federal government has been penalizing hospitals since 2012 for high rates of patients returning within 30 days of discharge. But now, nursing homes (or skilled nursing facilities) also are being held accountable for hospital readmissions.

14 Hospitals Penalized For Infection Rates, Injuries

Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized. The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program. The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized. New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C.

OSHA Penalties Drop Nearly 50 Percent In Five Years

Penalties levied against Connecticut companies for violations of occupational safety rules dropped by more than half between 2011 and 2015, and the number of cases with penalties fell by 40 percent in the same time period, according to a C-HIT analysis of federal Occupational Safety & Health Administration (OSHA) data. Data from the agency’s offices in Bridgeport and Hartford show initial penalties against Connecticut employers totaled $10.86 million in 2011 and dropped to $5.07 million in 2015. Companies were able to negotiate settlements, lowering penalty payments to $6.26 million in 2011, and $3.51 million in 2015. For the first nine months of 2016, the downward trends in cases and fines are continuing, the data show. Reasons for the declines vary: Government officials point to safer workplaces and more compliance with regulations.

Overdoses Fuel Increase In ‘Preventable’ Accidental Deaths

Connecticut saw one of the highest increases in the nation in preventable deaths from unintentional injuries from 2010 to 2014, mainly because of a spike in opioid overdoses, according to a new report from the Centers for Disease Control and Prevention (CDC). An analysis of the report shows that the state’s rate of potentially preventable deaths from accidental injuries jumped 97 percent – the sixth- highest increase nationally, after Maryland, Massachusetts, New Jersey, New York and Virginia. Nationally, preventable deaths from accidents – namely, overdoses from prescription and illicit drugs, as well as falls – rose 23 percent. Connecticut had 1,142 unintentional injury deaths in 2014— the second highest in New England, after Massachusetts. About half (568) were accidental drug intoxication deaths, according to the Office of the Chief Medical Examiner.

TB Cases Rise In Connecticut, Nationally First Increase In 23 Years

Reported cases of tuberculosis jumped 17 percent in Connecticut from 2014 to 2015, mirroring a national and global trend and prompting federal officials to ask primary care providers to be on the alert for at-risk patients. The state Department of Public Health (DPH) said 70 people, in 29 towns, were reported with active TB, the contagious form of the disease, in 2015, compared with 60 the year before. About 80 percent of Connecticut patients were foreign-born, many from Asian countries. Nationally, TB cases totaled 9,563 last year, an increase of 157 over 2014. It was the first jump in cases after more than two decades of annual declines, the U.S. Centers for Disease Control and Prevention (CDC) reported.

Handful Of Prescribers Responsible For Large Share Of Opioids

Ten Connecticut prescribers, including a Derby nurse who is at the center of a federal kickback probe, were responsible for more than 23 percent of the state’s Medicare spending on opioids in 2014, suggesting that the largest share of those prescriptions is concentrated among a small number of clinicians. Recently released federal Medicare data show that Heather Alfonso, formerly a nurse with the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, and four other advanced practice registered nurses (APRNs) at the clinic in 2014 dispensed more than $8.4 million in opioids in the Medicare program – accounting for a full 15 percent of all such prescriptions in the state. They were among the top 10 opioid prescribers in 2014, who accounted for $13 million of the $56 million spent on the drugs, the data show. More than 4,800 Connecticut clinicians, mostly physicians, wrote Medicare prescriptions for oxycodone, fentanyl and other opioids. But the prescribing was not evenly spread out – only two-dozen prescribers wrote out more than $250,000 worth of prescriptions.

Medical Errors Decline 3 Percent In 2015

Connecticut hospitals reported increases in patient deaths or serious injuries due to falls and medication errors in 2015 compared to 2014, but an overall drop in “adverse events,” according to a new state report. The report, by the Department of Public Health (DPH), shows that the total number of medical errors dipped by 3 percent – from 472 in 2014, to 456 in 2015. There were 90 instances when patients died or were seriously injured in falls, up from 78 in 2014. Seven falls that resulted in injury or death were reported at Yale New Haven Hospital, St. Vincent’s Medical Center and UConn’s John Dempsey Hospital.