Princess Health and Princess Health andNumber of Kentucky babies born addicted keeps rising quickly as heroin replaces harder-to-get prescription painkillers.Princessiccia

Princess Health and Princess Health andNumber of Kentucky babies born addicted keeps rising quickly as heroin replaces harder-to-get prescription painkillers.Princessiccia

children drug abuse health rankings pain prescription drug abuse prescription drugs

Gusty 20:50 Add Comment

Despite the crackdown on prescription painkillers, more Kentucky babies are being born addicted, "fueled by a recent spike in heroin use," much of it by people who have found prescription painkillers harder to get, Laura Ungar reports for The Courier-Journal.

"The state has seen hospitalizations for drug-dependent newborns soar nearly 30 fold in a little more than a decade � from 28 in 2000 to 824 in 2012, according to a recent drug report from the Kentucky Injury Prevention and Research Center. Preliminary figures suggest that number will surpass 900 in 2013, according to state officials," Ungar reports, in a follow-up to a series she did on the state's prescription-drug abuse problems in 2012.

"The financial cost is also high � and climbing exponentially," Ungar writes. "Hospital charges for drug-dependent babies in Kentucky rose from $200,000 in 2000 to $40.2 million in 2012, with $34.9 million that year paid for by government Medicaid," nearly 30 percent of which comes from Kentucky taxpayers.

"Although there are no state-by-state statistics, Dr. Henrietta Bada, a neonatal-perinatal medicine doctor at the University of Kentucky, said she believes Kentucky has one of the nation�s worst problems with drug-dependent babies." the Journal of the American Medical Association reported that U.S. hospitalizations for drug-dependent babies rose 330 percent from 2000 to 2009; "Kentucky�s hospitalizations rose more than 1,400 percent during that same time," but the state has "only 55 treatment centers serving pregnant and postpartum women, the vast majority outpatient facilities," Ungar reports. That's �a fraction of what we need,� Attorney General Jack Conway told her.

Princess Health and Princess Health andActivist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill.Princessiccia

Princess Health and Princess Health andActivist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill.Princessiccia

health-care associated infections hospital acquired infections hospitals lobbying nursing homes

Gusty 17:51 Add Comment

"Health-care industry witnesses appeared to have presented incorrect information" to the House Health and Welfare Committee in speaking March 6 against House Bill 460, which would require all health-care facilities to report infections associated with their treatment, Dr. Kevin Kavanagh of Somerset writes in an op-ed piece in the Lexington Herald-Leader. The bill remains in committee, but its goal could be accomplished by regulation.

Dr. Kevin Kavanagh

Kavanagh is chairman of Health Watch USA, a group that tries to focus attention on the problem of health-care associated infections, also called hospital-acquired infections. He said the industry witnesses "were asked if any of the various types of facilities in Kentucky were exempt from reporting. The answer was no, that all facilities had to report through the Centers for Disease Control's national reporting system. However, critical-access hospitals and ambulatory-surgery centers are not required to report infection to the CDC. Nursing homes also do not have to report through the CDC's system."

Kavanagh writes that nursing homes report urinary-tract infections to the federal Centers for Medicare and Medicaid Services, but "there is no data on the deadly staph infection, MRSA," or a deadly gastrointestinal infection caused by the bacteria C. Difficile, "which can run rampant in some nursing homes."

Kavanagh said the industry witnesses also misled the committee when asked "asked if a patient who was going to have hip surgery could find information on infection rates on Hospital Compare," a Medicare website. He writes, "The answers appeared to indicate that such information was available," but is "woefully inadequate" because the state doesn't have an adequate reporting system.

"For acute-care hospitals, only, bloodstream MRSA infections (a relatively rare event), colon surgeries, abdominal hysterectomies, urinary tract infections and central-line infection data can be found. Little use for patients needing hip surgery. In the past, CMS has posted on the Hospital Compare website information regarding hospital-acquired conditions, and was slated in the future to have information on neck and spine surgery. However, this information is now gone from Hospital Compare. I can only assume it, too, has fallen to the legions of health-industry lobbyists." (Read more)

For Kavanagh's March 6 testimony to the committee, click here. For his March 13 rebuttal to industry witnesses, go here.

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Princess Health andH+P Athlete Spotlight: Kimberley Chan.Princessiccia

Princess Health andH+P Athlete Spotlight: Kimberley Chan.Princessiccia

Gusty 15:07 Add Comment

There's no denying it: the 2013/14 Canadian winter made it tough to train. We had to battle the usual decreased daylight along colder-than-average temperatures, and a constant barrage of snow taking away our traction. These are great reasons to take it easy throughout the colder months of year, right? Maybe not...

Take for instance Kimberly Chan, a University of Waterloo student who joined H+P in the fall of 2013. She trained with us throughout the winter on a very consistent basis. The most impressive part: she comes from Mauritius. This is a very small country located in the Indian Ocean, about 2 000K away from the SE corner of Africa. To no surprise, it's a hot place to be with an annual LOW of about +16�C. So if +16� is cold, how does -30� feel? And how does one continue to train? Here's what Kimberly had to say:

H+P: Just this school year, you came from Mauritius, a country with an annual LOW of about +16�C. That being, said, you were one of the most consistent H+P runners this winter. What motivated you to keep running and working hard, even during the nights that plummeted below -30�?

KC: Frankly I think what played a big role is that I didn't know how cold is cold. As you said, I never experienced below +10�C so 5� was already cold for me. Seeing you all running at 5 degrees and saying "of course we run outdoors in winter" eventually made me develop the idea "if they can do it why can't I?". What also helped a lot is the people in the club itself. It's more encouraging when running as a group. I remember my first session; several of you were telling me "good job". I thought "are they really talking to me? I'm last, how is that a good job?!". But I definitely wanted (and still want) to get better. Finally I guess it was also about making new experiences. Like Sean said, "it's a story to tell". I won't forget that feeling after a good workout in a very cold weather.

H+P: Before coming here, did you ever experience snow? What was it like living through a Canadian winter for the first time? 

KC: I did come to Canada in December 3 years ago for holidays but it was my first real winter. When you're in holidays, you wake up late and do fun stuff like skating everyday. When you actually live in winter, it eventually gets to you after a while: dark when you wake up, dark when you get back home, no green, wearing bulky clothes... At least we get a clear blue sky from time to time, which makes me think of back home. The weirdest thing was certainly the big difference in sunrise/sunset times. In Mauritius it stays pretty constant so it took me some time to get used to waking up in the dark.

H+P: Another things that is impressive about you is that you show up to almost every workout, you work extremely hard every single time...yet you have no specific race or goal in mind. What do you want to get our your running long term?  

KC: Yes, unfortunately I haven't had the opportunity to do a race yet but it's definitely on my to do list. Race or not, I try to push myself everytime because I want to get better at what I'm doing. I think I have a tendency to never be satisfied but always aim higher.

H+P: You came here from Mauritius primarily for school. What are you studying, and why did you chose UW? 

KC: I'm finishing my first year in Mechanical Engineering. I always wanted to do my post-secondary studies abroad. I chose Canada because of the opportunities (work, facilities, sports...) and UW because of the co-op program. Aside from work experience, the fact that I would break my routine and discover a new environment every 4 months was appealing.

H+P: That is an extremely busy and challenging program. How do you manage to balance the demands of your school while still keeping up with your training?

KC: It is indeed but I've always set my priorities: studies and sports. So other activities like watching tv have to be sacrificed. I try to not waste time but use it efficiently. One thing that's sure is that without training my days wouldn't be very productive. If I do not work out after a few days, I get tired.

H+P: What is the presence of running and triathlon like in Mauritius? Do you plan on continuing with the sport when you return?

KC: There are races (track and field) at school level; that's where I started with the sport. However beyond that, it's barely developed. People generally go running on the mountains, volcano or horsetrack but there are practically no races. They tend to run as general fitness than competition. I know of only one big race for the whole country which occurs once a year. Triathlon is even less developed though its slowly getting more attention from the media. Of course, running is a great sport to do and I will certainly stick to it.

Princess Health and Princess Health andRogers, other drug-caucus chair file bill to reverse FDA's approval of new painkiller; competing company has alternative.Princessiccia

Princess Health and Princess Health andRogers, other drug-caucus chair file bill to reverse FDA's approval of new painkiller; competing company has alternative.Princessiccia

Congress drug abuse drug companies drugs Opana Oxycontin pain pain management prescription drug abuse

Gusty 18:51 Add Comment

Illustration from PainAndDepression.com

U.S. Reps. Hal Rogers of Somerset and Stephen Lynch of Massachusetts have introduced a bill to withdraw federal approval of a new formulation of hydrocodone that is highly addictive and produced in crushable pills, which they say threatens to start a new wave of prescription drug abuse. They are the Republican and Democratic co-chairs, respectively, of the Congressional Caucus on Prescription Drug Abuse.

But the Food and Drug Administration might act against Zohydro ER on its own, because Purdue Pharma LP has completed testing of a competing, non-crushable drug and will ask for "a priority review that would cut two to three months off the 10 months the agency sets as a goal to examine applications" for regulatory approval, Drew Armstrong of Bloomberg News reports. "Purdue�s pill is hard to crush and snort or inject."

That is important to the FDA. �If and when they, or another manufacturer, are able to create an abuse-deterrent formulation that remains safe and effective for patients, we would certainly give serious consideration to assuring that any non-abuse formulations are removed from the market,� FDA pain-drug director Bob Rappaport said in his Oct. 25 review of Zohydro�s approval.

Zohydro ER is an extended-release hydrocodone medication made by Zogenix Inc. for patients who need round-the-clock, long-term pain treatment and have found other treatments to be inadequate. Unlike recent formulations of the popular painkillers OxyContin and Opana, is not crush-resistant, but the company has said it is working on a crush-resistant version.

Citing concerns about abuse, the FDA's scientific advisory panel voted 11-2 against approving Zohydro ER, and a coalition of more than 40 health, consumer and other organizations urged the FDA to revoke its approval. Attorney General Jack Conway was among 28 attorneys general who sent the FDA a letter asking it to reconsider. Sen. Joe Manchin, D-W.Va., has introduced a companion bill to the one filed by Rogers and Lynch.

Hal Rogers (Associated Press photo)

Rogers said in a press release, "�While the FDA continues to send mixed signals to drug companies about the need to invest in abuse deterrent technologies, the Act to Ban Zohydro will make it abundantly clear � life saving measures are critical to the development of powerful painkillers like Zohydro. . . . In Southern and Eastern Kentucky, we lost nearly an entire generation when crushable OxyContin was first prescribed, and I fear this crushable, pure hydrocodone pill will take us backwards with a new wave of addiction and tragic, untimely deaths."

Kentucky ranks third in the nation for overdose deaths, with more than 1,000 Kentuckians dying each year from prescription drug overdoses. The number has leveled off following passage of laws that target pill-pushing clinics and doctors, and put stricter regulations on painkillers.

Zogenix has said it is committed to exceeding FDA requirements to make sure the drug is used appropriately, will monitor for misuse, and will allow an outside group to monitor and analyze its data. It noted that Zohydro ER will be regulated as a Schedule II drug, which means it can only be dispensed through a physician�s written prescription, with no refills, and does not contain acetaminophen, longtime use of which can cause liver failure.

Princess Health and Princess Health andHospitals try to do more with less while not compromising quality as they adjust to changes in the health-care marketplace.Princessiccia

Princess Health and Princess Health andHospitals try to do more with less while not compromising quality as they adjust to changes in the health-care marketplace.Princessiccia

health care health reform hospitals Medicaid obamacare Patient Protection and Affordable Care Act

Gusty 15:50 Add Comment

A. B. Chandler Medical Center at the University of Kentucky

Hospitals are laying off employees and cutting budgets because of changes in the marketplace and the ways consumers seek care, Editor Mark Green reports in an in-depth article for The Lane Report.

Now that consumers are paying more direct costs, they are paying more attention to prices and more likely to use out-patient procedures, which are cheaper, Green writes. Also, consumers are increasingly using wellness programs to avoid health problems, and "Taxpayer-funded government compensation models are making better medical outcomes and financial efficiency important bottom-line issues."

Less inpatient treatment means fewer employees are needed at Kentucky hospitals, but not all are financially burdened, Green reports; those who provide the best service at the least cost are increasingly reaping the profits.

While the Patient Protection and Affordable Care Act may make care more affordable, it also "puts pressure on health-care providers to keep costs in check,� Carl Herde, chief financial officer for Baptist Health, told Green. �However, many of the issues facing health care were in place before the ACA came into effect.�

Dr. Michael Karpf, administrator of UK HealthCare since 2003, told Green that hospitals are adjusting from a model that was based on volume to one that is based on value. Karpf has said for years that the "health-care industry is on an unsustainable financial course."

�There is a real need to decrease utilization to get healthcare costs under control. It just puts pressure on institutions,� Karpf told Green. �We won�t be doing business the same old-fashioned way we�ve been doing it.�

Some hospitals are still showing a healthy profit, but are also cutting costs and looking for increased efficiency, like UK HealthCare, whose $920 million hospital budget is producing a seven to eight percent cash flow, Green reports. But KentuckyOneHealth expects a $218 million deficit in its $2.5 billion budget, laid off 500 of its 15,000 workers last month, says that it won't fill 200 openings and will close the emergency room at Medical Center Jewish Northeast in Louisville on April 1. The company told Green that it might close an entire hospital, without telling which one.

KentuckyOne CEO Ruth Brinkley told Green, �The recession has come to health care, and that is causing the industry to transform. There are many causes for the changes, among them: the economy, reduced payments from government and commercial payers, increasing consumerism, and shifts in how care is organized and delivered. We have seen large and respected healthcare organizations announcing restructuring, budget cuts and layoffs. Among them are Vanderbilt University Medical Center and Cleveland Clinic. This situation is even more acute in Kentucky, with steep declines in inpatient volumes.�

Baptist Health, a Louisville-based system that has the most hospital beds in Kentucky, had a $22 million operating loss in fiscal 2013, but $78 million in investment income erased that deficit, Herde told Green: �There is increasing pressure for hospitals to do more with less without sacrificing quality, so we are exploring creative ways to contain costs, but we are financially sound now � and we are confident that we will remain so in the future.�

Owensboro Health's hospital (HGA.com photo)

When the state turned management of Medicaid over to insurance companies, that created higher administrative costs for hospitals, said John Hackbarth, chief financial officer for Owensboro Health, which in 2013 opened a $385 million medical center.

�After movement to a managed-care model, we have five insurance plans, plus some patients remaining on Kentucky Medicaid indemnity,� Hackbarth said. �This has increased costs in many areas such as contracting, compliance, billing, IT and case management because we are dealing with five times the amount of rules and hoops to jump through for a slower payment and ultimately less reimbursement.�

State officials say the expansion of Medicaid under health reform, to those with incomes up to 138 percent of the federal poverty level, is forecast to bring Kentucky providers an extra $15 billion for care and create 17,000 new jobs. But not yet.

Green reports that the most common response from five major hospital operators was that "Medicaid expansion eventually should lower their annual charity care and bad-debt burden, which is hundreds of millions of dollars." But first they are focused on adjusting their services to meet an increased demand for care by the formerly uninsured.

The Louisville region's biggest provider, non-profit Norton Healthcare expects that when the federal subsidy for expanded Medicaid is reduced, to 90 percent, the state will have to cut the number of Medicaid enrollees or reimbursements to providers. The reform law's overall impact to date, Gough said, is �decreases in Medicare reimbursements.�

Princess Health and Food Reward Friday. Princessiccia

Princess Health and Food Reward Friday. Princessiccia

Food reward Fridays

Gusty 03:00 Add Comment

This week's lucky "winner"... the Taco Bell waffle taco!!

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Princess Health and Princess Health andPoll: Kentuckians who report excellent or very good sidewalks and road shoulders are more likely to be physically active.Princessiccia

Princess Health and Princess Health andPoll: Kentuckians who report excellent or very good sidewalks and road shoulders are more likely to be physically active.Princessiccia

physical activity physical inactivity poll road safety walking

Gusty 19:17 Add Comment

Kentucky adults who ranked their neighborhood sidewalks and road shoulders as excellent or very good are more likely to be physically active, but only 26 percent of Kentuckians rank them that highly, according to the latest Kentucky Health Issues Poll.

"Adults who report excellent or very good neighborhood sidewalks/shoulders are more likely to report being very or somewhat physically active (84 percent) than residents who report fair to poor sidewalk/shoulder conditions (74 percent)," says a press release from the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health, formerly the Health Foundation of Greater Cincinnati.

"This finding stresses the impact of environment on activity choices," Susan Zepeda, president and CEO of the foundation, said in the release.

Despite the relatively poor rating for sidewalks and shoulders, more than half of those surveyed said their neighborhoods are excellent or very good locations to walk, jog, or bike.

Of those whose incomes are at or below 200 percent of the federal poverty threshold, 74 percent said they feel somewhat or very safe being physically active outside in their neighborhoods, but only 45 percent reported walking, jogging, and biking conditions as excellent or very good.

Only 11.9 percent of Appalachian Kentuckians rated their sidewalks and shoulders as excellent or very good. The poll defines Appalachian Kentucky as the 46 counties in the Big Sandy, Buffalo Trace, Cumberland Valley, Fivco, Gateway, Kentucky River and Lake Cumberland area development districts. Just 18.9 percent of Western Kentucky residents rated their sidewalks and shoulders as excellent or very good.

To see the full geographic breakouts, click here.