MMWR: Mass. reform narrowed insurance gap
Filed under: Health care reform, Health data, Studies
Studying data from the Massachusetts Behavioral Risk Factor Surveillance System has led researchers to conclude that health care legislation in that state has narrowed the gap in insurance coverage for underserved populations. The data did show that “some groups continue to experience lower rates of annual checkup and less access to a personal care provider.”
The percentage of respondents who reported having health insurance rose 5.5%, from 91.3% in the pre-law period to 96.3% in the post-law period.
The report, “Short-Term Effects of Health-Care Coverage Legislation — Massachusetts, 2008″ is in the March 12 issue of the CDC’s Morbidity and Mortality Weekly Report.
Some Mass. hospital quality measures online
Elizabeth Cooney, writing on White Coat Notes, alerts us to a change in data provided by the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives.
PatientCareLink, the new site, adds examples of hospitals improving their performance and, for patients, gives advice on choosing a doctor or hospital, according to Cooney.
The site allows you to view hospital staffing plans and performance measures, such as prevalence of bedsores, patient falls, heart attack care, pneumonia care and surgical care.
Some of the data comes from Hospital Compare (also participating hospitals. And there’s no apparent way to download the data for analysis, as you can from the Hospital Compare site (and AHCJ).
Of course, ratings of Massachusett’s hospitals also are available from the Massachusetts Health Care Quality and Cost Council.
Google charts health data from CDC, World Bank
Google has removed another step between people and information with the release of its new Public Data Explorer. It’s a service through which Google links neat, tidy and reputable sets of data with a beefed-up version of its chart programs.
Right now it’s limited to 13 data sets, though Google implies that it will continue to expand those offerings based on demand. Those data sets include three that are powered by the CDC’s WONDER data delivery platform.
Data from the World Bank includes international numbers on things such as fertility rates, births attended by skilled health staff, rates of immunization against measles, prevalence of HIV, life expectancy and more. You also can find statistics on the U.S. population from the Census Bureau.
At present, the limited selection mean that it probably won’t be useful for more than a handful of stories, but it’s something to keep an eye on as Google continues to add data and customization options.
Here’s a quick example mapping U.S. cancer rates (circle color) and number of cases (circle size) by state.
NOTE: If you can’t see the visualization, you’ll probably need to upgrade your browser.
ProPublica guides reporters to check local boards
Filed under: Government, Health data, Health journalism, Nursing, Public records, Tools
For those of you who have followed the ongoing investigation ProPublica’s Charles Ornstein and Tracy Weber have done into nurses and whether states are reporting disciplinary actions, you might have a chance to localize the story.
ProPublica has posted a guide, “Reporting Recipe: How You Can Investigate Your State’s Oversight of Its Nurses and Other Licensed Professionals,” to help reporters and the public check up on what’s happening in their states.
ProPublica editor-in-chief Paul Steiger and managing editor Stephen Engelberg, explain why they are providing the reporters’ techniques and insights:
We hope that others will use the techniques created by Ornstein and Weber to hold local officials accountable. Reporters who look into the local boards that oversee nurses or other health professionals will make new discoveries, some of which will undoubtedly go beyond what we have found. That, in turn, will help others push the story ahead. We hope statehouse reporters, beat reporters, general assignment reporters, bloggers, citizen journalists and others will use this road map.
Use the state-by-state guide prepared by Ornstein (also president of AHCJ’s board of directors) and Weber that shows what information is available to the public in each state and specific things to look for in the records.
They have used the data to identify some states that appear to be inconsistent in reporting disciplinary actions against medical professionals. If you are covering any of these states, you should probably be looking into the story yourself:
- Florida
- Georgia
- Illinios
- Indiana
- Kentucky
- Michigan
- Mississippi
- New Jersey
- Ohio
- Tennessee
- Wisconsin
- West Virginia
AHCJ: Joint Commission site obscures information
In a letter to Mark R. Chassin , M.D., the Joint Commission’s president and CEO, the Association of Health Care Journalists has suggested improvements to the commission’s Quality Check Web site, where many people go to find out whether to trust their local hospital.
The Web site also is a potentially useful tool for health-care journalists. “In a time of change in health care, the ability to do comprehensive research on local hospitals is more important than ever before,” the association’s letter said.
Among the problems identified:
- Hospitals with any level of accreditation are given “The Gold Seal of Approval” – even those whose accreditation is conditional or at risk of being denied.
- It’s difficult to find out which hospitals in a given region have less-than-full accreditation. To check on a hospital’s accreditation status, one has to open each individual profile. The Joint Commission once had a mechanism to sort hospitals by accreditation status, but that is no longer available.
- After a hospital loses accreditation, its past Accreditation Quality Reports are eventually removed from the site, leaving only the facility’s name with no historical record.
- There is no easy way to do a side-by-side comparison of more than six facilities simultaneously.
“The organization that accredits hospitals around the country, and voices support for transparency about hospital quality, has a Web site that obscures the reality of many hospitals’ performance,” said Charles Ornstein, AHCJ president.
Read more about AHCJ’s letter to the Joint Commission.
New CDC data pinpoint heart disease hot spots
Data from Medicare records of more than 28 million people each year between 2000 and 2006 in the 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands were used to create a county-level report on hospitalizations because of heart disease.
The CDC’s “Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries” shows that the highest hospitalization rates occur among blacks compared to other racial and ethnic groups and rates were highest in Appalachia, the Mississippi Delta, Texas and Oklahoma.
For more county-level health data, be sure to take a look at the County Health Rankings recently released by the Robert Wood Johnson Foundation and the University of Wisconsin.
Public records shed light on Texas blood samples
Filed under: Health data, Health policy, Hot Health Headline
The Texas Tribune’s Emily Ramshaw got her hands on almost a decade of public e-mails that help show the thoughts and intentions behind the state’s decision to store infant blood samples without parental consent. She also uncovered a previously undisclosed “transfer of hundreds of infant blood spots to an Armed Forces lab to build a national and, someday, international mitochondrial DNA (mtDNA) registry.”
Photo by valleyboy74 via Flickr
Ramshaw published PDFs of the e-mails alongside her story (E-mails, part 1 | E-mails, part 2).
Ramshaw’s report follows officials’ intricate dance around the issue of parental disclosure, as well as their reluctance to publicize the warehousing of the blood samples. Here’s her summary:
For decades, the state has screened newborns for a variety of birth defects, pricking their heels and collecting five drops of blood on a paper card. Until 2002, the cards were thrown out after a short storage period. But starting that year, the state health department began storing blood spots indefinitely, for “research into causes of selected diseases.” Four years later, DSHS began contracting with Texas A&M University’s School of Rural Public Health to warehouse the cards, which were accumulating at a rate of 800,000 a year. State health officials never notified parents of the changes; they didn’t need consent for the birth-defect screening, so they didn’t ask for it for research purposes. The agency’s rationale was that it let parents who asked opt out of the newborn blood screening and de-identified all of the samples before shipping them off.
According to Ramshaw’s sources, baby blood spots are “incredibly valuable” to researchers, and can be useful even when stripped of all identifying information. Yet public perception doesn’t line up with this scientific value in part, Ramshaw says, because scientists are unwilling to even try to explain the use of blood spots because it’s such a controversial topic.
Fortunately, Ramshaw writes, the first steps toward educating the public are now being taken. Parents are being asked for their informed consent when the blood samples are taken, and the state health agency has made a clean break with the past by destroying the earlier blood spots collected without full consent.
Papers combine forces to investigate group homes
Reporters from The Oklahoman and the Tulsa World teamed up to report on Oklahoma’s residential care homes and “Intermediate Care Facilities for the Mentally Retarded,” which are homes for developmentally disabled people. [Oklahoman | Tulsa World]
In their review of more than 40,000 records from federal, state and local agencies, including inspection and investigative reports and letters, the reporters found more than 800 violations, including inappropriate medical care, abuse and neglect. Four cases involved the death of a patient.
Inspectors documented residents who were covered in feces, stolen from, or left to sleep on dirty mattresses.
Some were supervised by felons. Others lived in buildings infested with ants, cockroaches and mice.
At least two people were allegedly raped.
Residential care homes, intended for people who are ambulatory and don’t require routine skilled nursing care, are only inspected once every two years.
The reporters created an online database from the records. The state’s health department is in the process of scanning inspection and investigation reports of group homes to put them on its Web site, a project it expects to complete by the end of the summer.
The report also looks at what a proposed cut in funding might mean for Oklahoma’s group homes and how current shortfalls are delaying community care services for thousands.
The project was done by Tulsa World reporters Ginnie Graham, Gavin Off and Michael Overall and Oklahoman reporters Sonya Colberg, Ann Kelley and Vallery Brown. A sidebar explains more about the series.
Reporters use county rankings for analysis
Filed under: Health data, Public health, Public records, Studies, Tools
On Feb. 17, rankings of the relative health of counties in each American state were released by the Robert Wood Johnson Foundation and the University of Wisconsin. The rankings used data from 13 distinct (mostly federal) sources, including the National Center for Health Statistics, the Census Bureau and the Dartmouth Atlas. With that data, researchers computed eight separate composite scores, which were then weighted to produce one overall score. The ratings are navigated by clicking through a national map to the state and county level. Enough clicks will even bring you to the raw data itself. The state only compares counties, not states, because data collection varies from state to state and isn’t always standardized.
It’s a combination of data, analysis and an intuitive interface, and journalists have been quick to localize the story. Many reporters reached beyond the easy numbers (”our county is 67th!”) to use the system for deeper stories.
For example, Robin Erb of the Detroit Free Press dissected the ratings process and how individual factors and disparities played into them before launching into the standard state breakdown.
Writing for Health News Florida, David Gulliver took a broader state view and considered how various socioeconomic factors played into the rankings of Florida counties. Gulliver’s analysis:
The strong-performing coastal counties, like Collier, St. John’s Sarasota, Charlotte, Palm Beach and Broward, all benefit from having heavy concentrations of retirees who have guaranteed health care access via Medicare. …
[Dr. Kevin Sherin, director of public health for Orange County] said that in Florida’s tourism and service industries, workers tend to be transient and less likely to have insurance or consistent primary care.
He noted the low-ranked counties were some of the poorest in Florida, like Union and Bradford in the rural north, and Glades and Okeechobee, with heavy populations of migrant workers. Those counties also tend to have more people who speak only Spanish, Creole or other languages.
Gulliver localized the story on a county level for his Sarasota Health News site.
In USA Today, Mary Brophy Marcus took the national view and looked for broad trends and generalizations. Marcus’ story was accompanied by a map by Frank Pompa highlighting each state’s healthiest and least healthy counties.
Defaulted doctors: Hundreds fail to pay on loans
More than 300 health care providers who received Health Education Assistance Loans made no payments during 2008, despite having earned income that year, according to a new report from the Office of the Inspector General of the Department of Health and Human Services.
These 312 HEAL defaulters earned $13.4 million and owed $47.5 million on their loans in FY 2008. Ninety-eight of these defaulters (31 percent) earned $50,000 or more. These 98 defaulters were responsible for nearly $15 million of the $47.5 million owed.
The program, known by the acronym HEAL, provided federal insurance for educational loans made by private lenders to more than 156,000 graduate health professions students between 1978 and 1998. Loans were available to students in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, public health, pharmacy, chiropractic, health administration or clinical psychology.
The names of borrowers who are in default on their loans are published online in a searchable database quarterly. Information available includes the borrower’s name, discipline, state, amount due, school and date of graduation or separation.
The site says it lists borrowers who:
- had one or more default claims paid by the Department of Health and Human Services (DHHS);
- been excluded from the Medicare program as a result of his or her HEAL default; and
- not had the Medicare exclusion stayed, or lifted, by the Office of Inspector General as a result of entering a settlement agreement.
The site says it was last updated in November 2009, so reporters will need to verify any information found on the site. But it could be a starting place for stories about local health care providers.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
