Wednesday, October 29, 2008
Monday, October 27, 2008
Sunday, October 26, 2008
Hazel, looking annoyed on the dining room chair. She hid most of the weekend while Guy's friends were here, but she came out to pee on my yoga mat on Sunday afternoon after everyone left. There is nothing passive about that cat's aggression.
Wednesday, October 22, 2008
Tuesday, October 21, 2008
I know I've been posting on this topic a lot lately, but in my feeble head universal health care = more patients in the system = more buildings and spaces needed to serve them = more work for me. I find this article interesting and question-provoking, not the least of which is: WHY? After reading Malcolm Gladwell's Blink, I have to wonder if something very, very subtle is a work here. Does minority = not worth givng the very best of care? Or does non-insured = not worth saving?
Minority, uninsured trauma patients more likely to die in ED, study suggests
Black, Hispanic, and uninsured trauma patients are more likely to die in U.S. EDs compared with white patients, but insurance status has the stronger association with mortality after trauma, according to a study published in the October issue of the Archives of Surgery. To determine the effect of race and insurance status on trauma mortality, researchers from Johns Hopkins University School of Medicine and colleagues analyzed outcomes for 376,897 patients in the National Trauma Data Bank. Treated between 2001 and 2005, the study sample included 72,249 black patients, 41,770 Hispanic patients, and 262,878 white patients; patients ranged in age from 18 to 64 and had moderate to severe injuries. Overall, 47% of patients had insurance, but blacks and Hispanics had higher uninsured rates than whites. The researchers found an adjusted mortality risk after trauma that was 17% higher for black patients and 47% higher for Hispanic patients than for white patients. Meanwhile, the researchers found that insured patients had a lower crude mortality rate compared with uninsured patients, at 4.4% and 8.6% respectively. The absence of health insurance increased a patient’s adjusted mortality risk by nearly 50%. According to the lead author, the dramatic differences in mortality risk between insured and uninsured patients were unexpected, given that access to trauma care in the United States does not hinge on insurance status. However, among insured patients, both Hispanics and blacks had “significantly” higher mortality risks compared with white patients, suggesting that “racial disparities in trauma mortality cannot be completely explained by insurance status alone.” As such, the researchers recommend further research into the “underlying reasons for these differences, which will enable to development of interventions to close the gap between patients of different races and payer statuses” (Haider et al., Archives of Surgery, October 2008 [subscription required]; Phend, MedPage Today, 10/20; Reinberg, HealthDay, 10/20).
Either way, this study at least suggests that having insurance might save your ass in the ED. Let's also remember from some earlier posts here (and studies elsewhere) that the ED is the main place where uninsured people go for all healthcare because they can't be turned away. It may be more likely, I dare posit, that the uninsured have a higher mortality rate in the ED because they wait too long for treatment and come to the ED when it's too late. Which is a condition that universal health care would very likely alleviate.
I know my posts have been shoddy lately, and I intend to rectify that as soon as possible. It's hard to talk about architecture when I've actually spent 3.5 days this month cleaning my desk and not working on a whole lot of real architecture.
Sunday, October 19, 2008
Friday, October 17, 2008
Tuesday, October 14, 2008
Saturday, October 11, 2008
Wednesday, October 8, 2008
Here's an idea: let's run nonurgent needs through an outpatient clinic, like we're supposed to! The ED is for emergencies, not nonurgent care.
I've heard a developer and a finance guy each cast aspersions at a national health care plan, saying it would mess up/foul up the healthcare design and construction industry. I'm having a hard time seeing how. If suddenly, 41+million Americans (with Social Security numbers, I might add) had health care, wouldn't you need a hell of a lot more treatment spaces for those people? If the funding came to provide that care, instead of becoming the black hole that is nonurgent-indigent-care-at-the-ED, hospitals might have more cash to pay nursing staff to extend hours of treatment and/or build or remodel those treatment spaces.
Do we have any healthcare providers in the crowd interested in sounding off on this?
Sunday, October 5, 2008
Spacing them close together allows them to "steam" on each other while they bake. Pop 'em in the oven at 450 for 10 to 15 minutes, depending on weather, elevation, flour type, etc. I use Hungarian high altitude flour.