Stories from Texas Medicine, March 2013

The Journal of Texas Medicine: March 2013 - 05/13/2016

We explored the characteristics of general medical hospital admissions for patients in state mental health hospitals. Data were extracted from a statewide database of all hospital discharges for 5 years identified as general medical hospital admissions that occurred during the stay of patients at state mental health hospitals. Across the 9 mental health hospitals in the state system, rates of admission to general medical hospitals varied significantly from 0.7% to 3.7%. On average, of the 1.9% of all state mental health inpatients who had a general hospital admission, 25% occurred within 4 days of admission to the mental hospital. The average general hospitalization lasted 5.7 days. The reported total charge for all stays was $34 million. Dehydration (15%), hypertension (10%), and diabetes (10%) were the most frequent diagnoses. Thirteen percent of diagnoses met preventable hospitalization criteria. Given the variability among hospitals in admission rates and the number of preventable ...


Real Meaningful Use - 05/13/2016

Researchers at The University of Texas at Austin are helping practicing physicians and other health professionals use electronic health records to wean smokers off tobacco. That's important because UT's MD Anderson Cancer Center says patients are 30 times more likely to enroll in tobacco cessation counseling if a clinician refers them than if they merely receive information about services. Researchers developed the e-tobacco protocol to improve patient referrals to the state-funded Texas Tobacco Quitline, a free, confidential, and 24-hour, 7-day-a-week service. It offers three to five phone counseling sessions and two weeks of nicotine replacement therapy to those referred by a physician or other health professional.


Part of the Team - 05/13/2016

Physicians play a pivotal role in assessing students' fitness for athletics and other extracurricular activities and in helping Texas schools adopt effective health policies. Whether they're on the sidelines at sports events, attending school health advisory council meetings, or examining patients in clinic, physicians can dramatically affect student health and well-being. Texas Medical Association policy on physician examinations for young athletes takes into account that these exams provide an entry point into health care for young Texans who may not have regular access to a primary care physician. The policy outlines TMA's support of student involvement in sports and other physical activities and eliminating barriers that prevent students from participating. TMA supports changes in the Texas Education Code to require that only licensed physicians or appropriately supervised physician assistants or advanced practice nurses licensed in Texas conduct athletic preparticipation physical ...


Medicaid Makeover - 05/13/2016

The Medicaid 1115 waiver program had lofty goals to make Medicaid work better, including accountability. But its financing mechanism favors hospitals and in some case is creating bureaucracies and funding disputes that overshadow the waiver's goals. That is drawing attention from lawmakers.


Is the Price Right? - 05/13/2016

Created by the 2011 Texas Legislature, the Texas Institute of Health Care Quality and Efficiency was directed to study three broad topics and report back to the legislature: improving the quality and efficiency of health care delivery by developing things like reportable measures; implementing innovative payment and delivery systems; and enhancing the reporting, organization, and transparency of health care data. Discussions on the latter sparked heated debate among the institute's board members in their charge to more specifically look at whether requiring physicians to publicly report the payment amounts they accept for specific services, and to stick to them, could help consumers make more informed health care decisions. A majority of the board members rejected the proposal in the institute's report to the legislature. Instead, they pointed to existing remedies that allow physicians, hospitals, and health plans to estimate patients' out-of-pocket costs, and recommended additional so...