Monday, March 15, 2010

ACC.10


Taking a brief break from my self-assigned pregnancy beat, I attended one day of ACC.10 – the 59th session of the American College of Cardiologists in Atlanta yesterday. A couple of story ideas came from it.

There were three posters that I’d like to find a way to work into one story and (but how?) relate to Madison Co.

• “Government-Sponsored Health Insurance and Lack of Insurance Are Associated with Adverse Cardiac Effects.”

• “Money Left Over at the End of the Month and Outcomes After Myocardial Infarction.”

• “Medical Cost Burden and Outcomes After Acute Myocardial Infarction.”

All three support the theory of Unnatural Causes: financial stress has an adverse effect on your health.

I’m not sure what the news article would be here. Just to say that these studies were done and what the result was? Is that enough? How to relate to Madison Co.? Sure, I know the people who care for the financially stressed in Madison County, but what to ask them?

The other story ideas came from the session on the Hospital to Home initiative (H2H). 25% of patients with cardiovascular disease are readmitted to the hospital within 30 days of discharge, and H2H’s mission is to reduce this rate by 20% with the collaboration of hospitals across the country.

I’m interested in two aspects of this initiative:

Community Collaboration: The focus of H2H is on improving the transition from hospital to home through follow-up home visits, phone calls, education, overseeing of meds, etc., and the creators of the initiative emphasize the importance of the community, such as pharmacists and community organizations, in helping carry out its mission.

This was interesting to me because I recently spoke with Gary Rost, executive director of Savannah Business Group on Health (SBG), who has been working on the development of a coastal Georgia health coalition for the past few years. Rost believes that no single health organization – such as public health – can possibly respond to the health needs of all the people. He believes the health coalition concept (or strategic partnerships, as H2H calls it) is “absolutely” the answer. Both SBG and H2H hold that the health of the community is the responsibility of the whole community.

Dr. Zsolt Koppanyi, director of the West Central health district (Columbus, GA), said that even though public health has beautiful plans in place for all types of situations, there simply aren’t enough people to carry out these plans. Finally, I spoke last week with Kevin Caspery, an MPH who works for a private firm that does consulting for the CDC. He commended the CDC for its reaching out to so many branches of the community in order to create strategies; he also seemed to feel that this is the way to respond to health needs.

So my story idea is the community health coalition as a possible solution to a public health system that has no money and is severely understaffed.

Transportation and Health: One way H2H wants to improve the transition home is through scheduling follow-up appointments for dates sooner after discharge and making sure the patient actually has a way to get there. The speakers in this session said that too often follow-up appointments are not kept and, when scheduling the appointments, healthcare providers don’t ask the patient how he/she will get there.

This reminded me of Madison County. In my first meeting at the cooperative extension, Debbie Phillips told me that lack of transportation is too often a barrier to the poor getting care and services that they need. County nurse manager Beth Heath has also mentioned lack of transportation as a significant barrier to getting proper care. This is compounded in Madison County by lack of any public transportation – or even a sidewalk for that matter – no hospitals and only a private ambulance service. We don’t always think that whether or not one owns a car could impact one’s health.

Maybe this is a story idea?

3 comments:

  1. I like the transportation idea. Those of us who have cars tend to forget those who don't - and there are a lot of people who don't. I see relatively young people walking up the extremely busy Mitchell Bridge Road on a regular basis. I wonder what could be done to help people in Madison County who don't have transportation. Maybe there's a program that's working somewhere else they could model...

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  2. Great coverage of your beat, I'm thoroughly impressed!

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  3. Excellent updates!! I wonder: Is there a taxi service in Madison? Usually taxis are cost-prohibitive, but they are a form of transportation in case of a health emergency. Stephanie's comment makes me wonder if other rural communities without means of mass transportation have a program in place. A car tree, so to speak? (Instead of a phone tree.. remember those..) What I really like about that topic is that it is so simple -- "no car, no health care" -- and yet so completely overlooked. If you find numbers about how many lives could be saved with some improvements in community transportation--that'd be super-cool.

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