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ProPublica Launches New Site To Investigate Nursing Homes

Check out Propublica’s new interactive tool for DIY nursing home investigations. The database allows anyone to search over 20,000 nursing home inspection reports, most fairly recently posted online, that encompass “nearly 118,000 deficiencies.”

Charles Ornstein, ProPublica’s lead reporter on the Nursing Home Inspect project explains:

Why is this so cool and helpful? This is where you can look for patterns of problems at nursing homes in your area.

Searching for the phrase “pressure sore” returns 2,121 results. Searching for the phrase “bed sore” returns 1,946 results, some of them duplicates. But other words that also can return deficiencies related to bed sores include: decubitus, purulent and pus, as well as stage iii and stage iv (phrases that describe the most serious and dangerous sores, but can also describe cancer progression).

Another example: Sexual assaults. Though uncommon in nursing homes, 88 reports include “rape” and 120 include “sexual assault” (there is some overlap). A broader search for the word “sexual” yields far more results, 787. Continue reading

Big Weather Swings Could Hurt Health, Especially Of Old And Sick

(Jo3design/flickr)

In case you missed this piece on Radio Boston yesterday, take note: wild fluctuations in the weather (which we endured this winter and may face this summer) can be bad for your health — even possibly fatal if you are elderly and suffering from a chronic medical condition, according to a new report by researchers at the Harvard School of Public Health. And this phenomenon of crazy swings in the temperature is predicted to worsen as climate change progresses.

“Day to day changes in temperature…that’s what seems to be dangerous,” Joel Schwartz, professor of environmental epidemiology at the Harvard School of of Public Health tells Radio Boston. He adds: “We think its very likely that the health impacts are going to get worse in the future.”

From the Harvard press release:

New research from Harvard School of Public Health (HSPH) suggests that seemingly small changes in summer temperature swings—as little as 1°C more than usual—may shorten life expectancy for elderly people with chronic medical conditions, and could result in thousands of additional deaths each year. While previous studies have focused on the short-term effects of heat waves, this is the first study to examine the longer-term effects of climate change on life expectancy. Continue reading

High Heat: How It Works, And Why Being Fat Adds To Risk

With a heat wave sweeping much of the nation, including a heat advisory now out for Boston, today’s excellent Los Angeles Times story on what extreme heat does to the body should be required reading.

It includes some fascinating physiological facts: Heat makes your heart beat faster to increase blood flow to the skin. For every Centigrade degree that your body’s “core temperature” rises, your heart has to beat 30 more times per minute. And once your core temperature hits 103 degrees, organs may begin to fail — in other words, I can’t resist saying, you’re cooked.

I knew that old people were particularly at risk, but the LA Times reports that obese and diabetic people are as well:

People over age 60 are most vulnerable to suffocatingly hot conditions. But if you’re not fit, if you’re overweight or if you suffer heart disease, diabetes or respiratory problems, you’re also at high risk because these conditions can hamper the body’s ability to regulate its core temperatures in extreme heat.

Fatal heatstroke occurs 3.5 times more frequently in overweight or obese adults than those of average body weight, according to research published last year in the Canadian Medical Association Journal.

Field Test: Does Bob Master Hold The Secret To Better Health Care?

As part of our ongoing coverage of health reform and the cost of care, CommonHealth will periodically investigate novel approaches to delivering high quality, affordable medical care. We begin the series with a look at Bob Master’s Commonwealth Care Alliance, a nonprofit that has reduced the hospitalization rate of its chronically ill, elderly patients by nearly half since the first enrollee signed on in 2004.

Bob Master, CEO, Commonwealth Care Alliance, a unique health care delivery organization

Step into the downtown Boston office of Commonwealth Care Alliance, and the first thing that hits you are the walls — they’re a screaming, deliciously bright shade of orange — not the typical palette for a health care business. But that’s the point.

As CEO of this unorthdox hybrid — part health care provider, part HMO, part payer — Dr. Bob Master must take on multiple roles. “We have to play the insurance game,” he says. “But that’s not our primary role.”

Reinventing Primary Care

Dr. Master’s ultimate role has been to re-imagine health care delivery. Commonwealth Care front-loads primary care and supports physicians in its network with a dedicated team of nurse practitioners, mental health and behavioral specialists, geriatric social workers and “every medical and surgical specialist known to man.”

The organization is essentially a full-service provider of medical care and social support for chronically sick, elderly and sometimes disabled people on Medicare, Medicaid, or both. From the moment a patient signs on, he or she has access — 24 hours a day, 7 days a week — to a nurse practitioner who is armed with up-to-date electronic medical records and has the authority to call in other specialists as needed. Patients can choose from 25 primary care sites around the state, and for the homebound, house calls are also part of the plan. Continue reading