Long ER Stays For Kids In Crisis On The Rise

Just a few years ago, it was rare that children with mental health problems would spend two or more nights in the emergency room at Connecticut Children’s Medical Center. Only 40 children stayed that long in 2010. So far this year, more than 250 children have spent multiple nights in the emergency department (ED) – a number expected to reach 500 by the end of the year. As policy makers work to finalize a statewide children’s behavioral health plan, a report by the hospital, obtained by C-HIT, projects that children with mental health problems will spend a total of 3,085 nights in the ED – more than triple the number in 2010. The average stay is about 15 hours, with some children remaining in the ED for 10 days or more.

State’s Child Care Oversight: Minimal Monitoring, Lax Enforcement

On its website, the Tumble Bugs Day School in Norwalk boasts a “highly experienced, nurturing” staff who serve infants and toddlers in a “stimulating setting.”

But a review of state Department of Public Health records shows the child care center has had numerous complaints and citations in recent years for lapses in supervision that have injured and traumatized young children. In 2010, the center failed to notify parents when a balancing board fell on a toddler. The same year, DPH cited the center for failing to take action against a staff member who restrained a toddler on a cot by “holding down his head and body” and then falsely reported that a scratch on the boy’s face was an accident. Then, in 2011, two children came forward to report that a preschool teacher had sexually abused them during naptime – an allegation that led to the April 2012 arrest of a 44-year-old Harold Meyers, who worked at the center in 2008 and 2009. DPH investigated the case last year, but determined that the center had made oversight changes and that no further action was needed.

Long ER Waits: Half Of CT Hospitals Over National Average Of 28 Minutes

In more than half of Connecticut’s emergency rooms, the waiting time to see a health-care provider exceeds the national average of 28 minutes – a problem that experts say could get worse, as thousands more residents obtain health insurance. The average wait can stretch to an hour or more at Rockville General, Manchester Memorial, Bridgeport, Waterbury and Hartford hospitals, according to a C-HIT review of federal data. The statewide average waiting time is 30 minutes. The longest wait time is at Hartford Hospital, where patients were not seen for 82 minutes, on average; the shortest wait of 14 minutes is at Windham Hospital, the data compiled by the Centers for Medicare & Medicaid Services (CMS) through 2012 show. Officials at Hartford and Bridgeport hospitals claim shorter wait times than the federal data.

Brand-name Drug Choices Drive State’s High Medicare Costs

Connecticut seniors on Medicare are more likely to take sedatives for insomnia and medications for depression than their counterparts across the country, according to a new report by Dartmouth researchers. An analysis of state data in a national report by the Dartmouth Atlas Project also shows that Connecticut’s Medicare program relies heavily on brand-name drugs, versus generics, especially in wealthy towns in Fairfield County – a factor that could be contributing to the state’s ranking in the top 10 nationally in prescription drug spending per patient. Connecticut seniors spent an average of $2,795 on medications in 2010 – 45 percent higher than the lowest-spending state, Minnesota, and the highest rate in New England. The new report provides an in-depth look at how prescription drugs are used by Medicare beneficiaries, age 65 and older, in the program’s Part D drug benefit, which had 37 million enrollees in 2012. It shows wide variations in the use of both effective and risky drugs among the 306 regional health care markets across the U.S.

While the underlying health status of populations is a factor in prescription drug use, “it really does not explain the variations in drug use intensity that we observed,” said Dr. Nancy Morden, a lead author of the study.

Hospitals Mobilize To Tackle Alarm Fatigue

At Bridgeport Hospital, “talking bed rails” programmed to speak to patients in the geriatric psychiatric unit are helping to reduce the number of alarms that sound when a patient at risk for falling tries to get out of bed. At the Hospital of Central Connecticut in New Britain, health care professionals are adopting techniques from aviation safety experts to reduce the chances of a catastrophic event happening before a clinical alarm goes off. These are among the many ways Connecticut hospitals are tackling a phenomenon known industry-wide as alarm fatigue. Health care experts worry that medical devices with built-in alarms – such as heart monitors, infusion pumps and ventilators – designed to alert caregivers that patients are in danger could potentially put patients at risk because caregivers are desensitized by the sheer number of alerts and false alarms and fail to respond in a timely fashion. Research shows alarms in intensive care units are accurate less than 10 percent of the time, and 90 percent are false alarms.

Solutions for combating alarm fatigue range from alarm integration technology that sends alerts to a caregiver’s telephone to the development of a new generation of “smart alarms,” including ones designed to monitor multiple vital signs.

Study Finds Big Geographic Swings In Psychotropic Drug Use

In Alexandria, Va., the rate of antidepressant use is the highest in the country, with a full 40 percent of residents receiving prescriptions. Cape Cod, Mass., tops the country in the use of stimulants, with 16 percent of the population filling at least one prescription, compared to a mean of 2.6 percent nationally. Gainsville, Fla., has the highest utilization rate of antipsychotics – 4.6 percent of residents, well above the national mean of .8 percent. Usage rates of the three classes of mental health medications vary widely across the U.S., with Connecticut in the middle, according to a new study by the Yale School of Management. The study found that much of the geographic variation could be explained by access to health care and pharmaceutical marketing efforts, rather than by the underlying prevalence rate of the psychiatric disorders.

Life spans by counties in Connecticut

Women’s Longevity Falling in Some Parts of U.S., Stress May Be Factor

It’s one of the most disturbing trends in American public health: women’s life spans are shrinking in many parts of the U.S., and no one knows why. Women’s longevity took an unprecedented nosedive during the past decade, researchers recently discovered, with their life expectancy tumbling or stagnating in one of every five counties in the country. In Connecticut, where women’s life expectancy exceeds the national average, New London County saw a drop in longevity, while Fairfield and Hartford counties saw significant jumps. The last time life expectancy fell for a large number of American women was in 1918, due to Spanish influenza. While many scientists believe that smoking and obesity are driving the downward spiral, a growing chorus of experts contends that chronic stress may be a key culprit, too – especially the stress of juggling work and family.