In May 2017, Maura B. Gallagher entered Stamford Hospital for a Cesarean section for her unborn fraternal twins. According to a lawsuit filed by her family, Gallagher was 38 and an avid skier who was dedicated to her family, which included her fiancé, Max Di Dodo. There were signs that her pregnancy was challenging. At a little over 37 weeks, Gallagher, of New Canaan, showed signs of a low platelet count. The condition, known as thrombocytopenia, affects 7 to 12 percent of pregnant women.
As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports. Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.
Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.
Connecticut consumers were billed for more than $1 billion in facility fees for outpatient services in 2015 and 2016, documents filed with the state Office of Health Care Access (OHCA) show. Twenty-two of Connecticut’s 30 hospitals charged these fees, bringing in $600.7 million in 2015 and another $488.8 million in 2016, according to an analysis by Conn. Health I-Team. The state’s two largest hospital systems, Yale New Haven Health and Hartford HealthCare, accounted for almost half of the total facility fee revenue in 2016. Yale and its four hospitals billed $144.3 million; Hartford and its five hospitals, $80.9 million.
When the lights power on in the operating room at Bridgeport Hospital, more than a half of the acute care team of surgeons peering from behind the masks are women. That’s unusual, given that only 28 percent of all surgeons in Connecticut are female, according to the latest figures from the American Medical Association (AMA). Flexible work schedules and hiring more surgeons to ease the on-call burden has helped to lure more women to the trauma surgical team, said Bridgeport Hospital’s chief medical officer, Dr. Michael Ivy, a trauma surgeon. Hospitals statewide have launched initiatives to help boost the ranks of women surgeons. There’s been progress, but gaps persist.
A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.
Low-income women in Connecticut who have just given birth and know they don’t want to get pregnant again anytime soon are now offered a long-acting birth control option postpartum. Medical providers say the policy by the U.S. Department of Health and Human Services will reduce the number of unplanned pregnancies, as well as lead to better maternal health outcomes by ensuring pregnancies are spaced a healthy length of time apart. Connecticut’s HUSKY program is one of 26 state Medicaid programs nationwide that reimburses hospitals for administering long-acting reversible contraception (LARC)—namely, intrauterine devices (IUDs) and subdermal implants—to Medicaid patients. HUSKY started reimbursing for the devices last year. “It’s a great thing,” said Dr. Elizabeth Purcell, an obstetrician and gynecologist practicing in Hartford.
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.
Clattering carts, overly bright lights and frequent disruptions make hospitals a tough place to get a good night’s sleep. But now, hospitals across Connecticut are launching efforts to help patients sleep longer and better. At Yale-New Haven Hospital, researchers are expanding a pilot program that successfully reduced noise in the medical ICU and kept staff out of patient rooms overnight. At Hartford Hospital, where noise levels sometimes resembled airport runways, they’ve eliminated overhead paging on patient floors except in true emergencies. And Stamford Health’s new hospital building, slated to open in September, is designed with sleep in mind.
Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.