UK Hospital gets below average marks on patient satisfaction, infections; data on your local hospital are available online

Despite $900 million being invested in expanding the University of Kentucky Chandler Hospital, its patients at do not seem all that happy with the care they receive there.

In an op-ed piece in the Lexington Herald-Leader, Dr. Kevin Kavanagh of Somerset highlights the results of a survey on patients' hospital experiences. That survey ranked UK's hospital below state and national averages in nine of 10 measures. "Especially disturbing, only 66 percent said they would definitely recommend the institution, and only 56 percent stated their room and bathroom were 'always clean'," writes Kavanagh, chairman of Health Watch USA.

The UK hospital also did not fare well when it came to its assessment by the Centers for Medicare and Medicaid Services on hospital-acquired conditions. "UK had the highest reported rate of deadly vascular catheter infections in the state," Kavanagh writes. "UK also had an unacceptably high rate of falls and deep bed ulcers. These latter conditions should be zero."

Kavanagh concluded, "If there are quality problems at UK, it is of paramount importance that they are corrected since not only current patients are at risk but also the quality of the training experience of our future clinicians, which can affect care for years to come." (Read more)

Newspapers can access information about their area hospitals by clicking here. Viewers can choose up to three hospitals and see how they compare to one another in categories like: how well nurses communicate with patients; how quiet the areas around patients are; if patients would recommend the hospital; and if patients always received help as soon as it was wanted.

Newspapers can also see the results of the CMS assessment on hospital-acquired conditions for their area hospitals by clicking here and downloading the Hospital-Acquired Condition Rates zip file (scroll down to Kentucky hospitals). The file contains data on eight hospital-acquired conditions reported between Oct. 1, 2008 and June 30, 2010. Among the conditions reported are air embolism; blood incompatibility; catheter-associated infections; falls and trauma; foreign objects left in the body after surgery; pressure ulcers; uncontrolled blood sugar levels; and urinary tract infections.

Kentucky Rural Health Assn. gives first newspaper writing awards; Kentucky Health News writer wins for previous work

Tara Kaprowy, the chief writer for Kentucky Health News, won one of the first awards given by the Kentucky Rural Health Association for newspaper writing.

Kaprowy won the prise for best series in a non-daily newspaper for her five-part series in The Sentinel-Echo of London titled “How Healthy Are We?” The August 2010 series examined how Laurel County compared to state and national averages for tobacco use, obesity, access to health care, and so on.

Ivy Brashear, formerly of The Hazard Herald, won prize for best story in a non-daily paper for her April 6, 2011, article, “Health study has Perry near the bottom,” about a Population Health Institute study that ranked Perry’s health status as 115^th among the state's 120 counties. There were no daily entries; each winner received a plaque and $100 prize.

These types of reports can be done by any news outlet in Kentucky, because plenty of data are available on sites such as http://www.kyhealthfacts.org/. For a look at Kaprowy's series, go here.

Website helps journalists, community planners, other Kentuckians in search of county-specific health data

A treasure trove of health data about every county in Kentucky is available to journalists and community planners looking to draw a statistical picture of their area. That was the message of a webinar hosted by the Foundation for a Healthy Kentucky Wednesday.

"We really hope the information we have on kentuckyhealthfacts.org will start a conversation," said Sarah Walsh of the foundation's "Local Data for Local Action" Initiative.

The website features a map of the state that is broken down by county. By clicking on a county, a plethora of information pops up, including information on a county's:

• demographics, such as graduation rates and per capita personal income;

• social and behavioral indicators, such as lack of physical activity and prevalence of smoking and obesity;

• health outcomes, such as infectious disease rates, motor vehicle deaths and premature death rates;

• access to care, such as flu vaccination rates, and number of available health care providers and physicians;

• maternal and child health, such as infant mortality, teen birth rates and low birthweight rates;
• senior health, such as the percentage of the senior population in a community.

The data can be compared to the rest of the state, the rest of the country or other counties, and users can create tables, bar graphs, line graphs or maps suitable for publication. "There's a lot of information here," Walsh said. (Graph created online shows obesity declining in Laurel and Pulaski counties after three years of increase, but still rising in Knox County and holding steadier in Rockcastle County. Up to six counties can be placed in one such graphic.)

The site is especially valuable to journalists, said Al Cross, director of the Institute for Rural Journalism and Community Issues at the University of Kentucky. "These are the hard facts that local news media need to report as they hold up a mirror to their communities and help them address community problems," Cross said. "In most Kentucky counties, one or more facets of health are a community problem. They need more attention." Kentucky Health News is a service of the institute, funded by the foundation.

Much of the data come from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance Survey, a nationwide, random telephone poll that is conducted each year. Because there may not be enough survey responses from residents in some counties, much of the data on the site have been developed by looking at three or four counties that are near each other and demographically similar, which Walsh said makes the data more "stable and robust." Statisticians have reconfigured the data so that they are all based on a population of 100,000 people, enough to have confidence in the percentages.

While encouraging community planners to use the site, Walsh said the Kentucky Cancer Registry website is "one of the best in the nation" and has cancer-specific data that may not be available on kentuckyhealthfacts.org. She also pointed listeners to the Kids Count website, an Annie E. Casey Foundation-funded project that has statewide data specific to children.

What surfers won't find, however, are Kentucky numbers on the childhood obesity or childhood diabetes. "Different school districts and communities are collecting data but in different ways and at different ages," she said, adding those disparities make comparison analysis difficult. A bill to make schools collect and report body-mass-index data failed in the last session of the General Assembly.

The goal of Wednesday's webinar was to disseminate information so community planners can identify and address health needs in their area. "At the foundation we take a lot of inspiration from the words of Arthur Ashe, 'Start where you are. Use what you have. Do what you can'," Walsh said. "We believe communities can do a lot to change their health status." The webinar was part of the foundation's "Health for a Change: Ignite — Unite — Act" initiative and was the first in an ongoing series. The next session, July 27, will focus on how to plan a community health needs assessment. For more information about the series, click here.

More county-specific health data are available, painting detailed pictures of your local area's health

Five years' worth of county-specific data are now available for many types of health indicators on the Kentucky Health Facts website. The site features data on demographics, social and behavioral indicators, health outcomes, access to care, and maternal and child health, much of which can be useful to journalists all over Kentucky.

The Health Outcomes category, for example, looks at a county's premature-death rate, motor-vehicle deaths, prevalence of asthma, diabetes prevalence and cancer deaths. The Maternal and Child Health category looks at adequacy of prenatal care, infant mortality rates, teen birth rates and prevalence of youth who smoke cigarettes. It compares that data to the rest of the state and nation.

The data paint a detailed picture of what is happening in a specific area. One interesting nugget in the newly updated data on asthma show that in Warren County (Bowling Green), the percentage of adults with the respiratory condition has nearly doubled from 10 percent in 2003-05 to 19 percent in 2007-09. Here is the county asthma map:

The data come from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, which is the world's largest ongoing telephone health survey. It has tracked health conditions and risk behaviors in the United States on an annual basis since 1984.

The data can be viewed by going to www.kentuckyhealthfacts.org or by clicking here. Kentucky Health Facts is a service of the Foundation for a Healthy Kentucky.

High use of meds earns Louisville bad name for allergies, which are becoming more common as pollination periods expand

Louisville is the second worst American city for spring allergy sufferers, based on use of allergy medicine, says the Asthma and Allergy Foundation of America. Though the city has only an average pollen score and an average number of board-certified allergists, it has an above average number of patients who use allergy medicine, the Spring Allergy Capitals 2011 survey concluded.

Only Knoxville, Tenn., ranked higher than Louisville. Charlotte, N.C., came in third, followed by Jackson, Miss., and Chattanooga, Tenn. "The worst cities are always in the South, where the temperatures are warmer and the plant life flowers earliest," Dr. Joseph Leija, an allergist who performs the Gottlieb Allergy Count, told research-reporting service Newswise.

Louisville ranked second last year as well, first in 2009, and 21st in 2008. In the past nine years the survey has been conducted, pollen concentrations have increased. "There's a lot of evidence that trees, grasses and weeds are pollinating more, said Mike Tringale, vice president for external affairs at the foundation. There is also evidence that the pollination season is lengthening, starting 10 to 15 days sooner and lasting 10 to 15 days longer.

As a result, more people are suffering. "Allergy prevalence has more than doubled in the past 30 years," Tringale said. "No one is really sure why. One of the leading theories is global warming." Today, between 12 to 14 percent of people have nasal allergies.

As for why some cities are affected more than others, Tringale said he didn't have an answer. Researchers will be looking at patterns and correlations next year in time for the 10th year of the study.

The study looked at the number of prescriptions that are written and refilled for all allergy medications, "whether eye drops, nasal sprays or oral pills," Tringale said. It also looked at all of the over-the-counter versions of allergy medicines that are sold at pharmacy counters, which account for about 20 percent of all over-the-counter sales. Medications sold at regular check-out aisles and at grocery stores were not accounted for, nor were medicines sold at Walmart. "Walmart doesn't give out data," Tringale said. Though Tringale acknowledged the low percentage of OTC sales tracked is a weakness of the study, he said it was done in this way "to standardize the data between cities."

Pollen counts were collected weekly "from thousands of different stations," Tringale said. The American Board of Medical Specialties provided the data regarding the number of board-certified allergists. (Read more)

Kentucky continues to lead nation in cancer death rate

Though cancer deaths rates are falling nationwide, Kentucky continues to rank worst in the country for its number of cancer deaths, The Courier-Journal's Laura Ungar has determined. (C-J graphic shows rates for the nation, Kentucky and Indiana, the southern part of which the Louisville newspaper serves.)

Ungar's analysis stems from Thursday's release of the Annual Report to the Nation on the Status of Cancer, which concluded cancer death rates declined about 1.6 percent each year between 2003 and 2007 nationwide. Kentucky's death rate declined an average of 0.7 percent each of those years.

The state had a cancer death rate of 213.7 per 100,000 residents in 2007, which translates to about 9,700 Kentuckians dying each year from cancer. In 2007, Kentucky had a lung cancer death rate 50 percent higher than the national average, ranking it highest in the nation. It also ranked eighth highest in brain and other nervous-system cancers and higher than average for colorectal, prostate and breast cancer death rates.

Lung cancer is the most deadly cancer in the country, though researchers found, for the first time, a decrease in the number of women who die from lung cancer nationwide. The decline comes "more than a decade after deaths began dropping in men," Ungar reports.

Doctors are hoping to make more strides in battling the disease in the years to come. Thomas Tucker, director of the Kentucky Cancer Registry, told Ungar that smoking bans, higher cigarette taxes and anti-smoking messages should help drive down lung cancer rates. There has also been progress in the percentage of Kentuckians who are getting colonoscopies, a screening for colon cancer. Though more Kentuckians died of colorectal cancer than any other state in 2007, the rate has declined since. (Read more)

County health rankings in Kentucky show few changes, but ranks are less important than the trove of data they reflect

By Tara Kaprowy
Kentucky Health News

The health evaluation tool that calls itself "the annual check-up of over 3,000 counties in the nation" was released today, showing little change from last year in how Kentucky counties compare when it comes to factors like obesity, smoking rates and mortality. But the data provide plenty of fresh angles for stories about the health status of individual counties and regions.

The County Health Rankings for Kentucky, which are compiled by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, ranked Appalachian counties at the bottom and Central Kentucky counties in the Lexington and Louisville markets at the top. The far western portion of the state ranked lower as well.

The rankings fall into two categories: health outcomes and health factors. Health outcomes, left, include factors such as premature death rates, low birthweight and how many days of the past 30 that someone said they felt bad physically or mentally. Boone, Oldham and Calloway counties ranked first, second and third in health outcomes category, and Wolfe, Martin and Owsley were at the bottom.

In health factors, right, Woodford, Boone and Fayette counties were first, second and third, and Jackson, Clay and McCreary at the bottom of the list. Health factors include the percentage of adults who smoke, are obese or drink excessively; and assess a county's health care landscape: the number of primary-care providers and what percentage of adults are uninsured, for example. Social and economic factors in this ranking include unemployment rates, high-school graduation rates, percentage of children in poverty, pollution rates, access to healthy food and the number of recreational facilities. (The last item replaced the number of liquor stores. "Some of the data were not available for the availability of alcohol and it was difficult to interpret," said Dr. Patrick Remington, project director and associate dean for public health at the University of Wisconsin. The change could have affected the rankings, because Kentucky has many "dry" counties and liquor stores often cluster in "wet" counties adjacent to dry ones.)

Interestingly, the rankings between the two categories vary considerably. Fayette County, for example, ranked third in the health factors list but 10th in the health outcomes assessment. McCracken County was listed eleventh in the health factors list but 45th in health outcomes.

Though Appalachian counties in Kentucky, West Virginia and Tennessee generally ranked very low, there was one very bright spot: Morgan County, which ranked 23rd in health outcomes despite being surrounded by counties that were down in the 100s. It also ranked high last year.

While the rankings didn't change drastically from last year, there was some deviation downward in the Southern Kentucky, including Adair, Clinton, Cumberland and Wayne counties. But Shawn Crabtree, executive director of the Lake Cumberland District Health Department, didn't see much reason for concern. "Naturally, the rank of counties are going to go up and down each time," he said. "I don't know that the communities are any sicker or that anyone is doing anything any different."

Crabtree said it is important to remember the assessment is ranking one county against another, not making a comment on if counties are getting healthier or not. "That's not to say our area isn't an unhealthy area; it is," he said. "That doesn't mean we don't need to improve; we do."

Also, statistical data from counties with small populations can greatly affect rankings. "That number is a little bit volatile," Remington said of certain disease numbers. "It's not a survey, it's the actual experience of what happened." He added, "When you present a statistic for an entire community, you realize it's an average. This is like a screening test. It tells people in a community where the problem areas are, but it really doesn't make the diagnosis."

 

Researchers assembled the snapshot county portraits with information from several sources, including the Behavioral Risk Factor Surveillance System, a random telephone survey by the Centers for Disease Control and Prevention. They also used data from the National Center for Education Statistics, the National Center for Health Statistics and the Census Bureau's American Community Survey and Small Area Income and Poverty Estimates. For a complete list of sources, click here.

Given the number of sources used and the conclusions drawn, researchers hope the data will spur community interest and, ultimately change. In a conference call with reporters, Mayor Joe Reardon of Kansas City, Kan., said, "It was a call to action for me personally and a wake-up call for our community."

Feds say they will post data on performance of dialysis centers

"Federal regulators say they are moving to make once-confidential data about the performance of kidney dialysis clinics more readily available to the public," reports Robin Fields of ProPublica, the nonprofit, investigative news group that posted the data online in December. (ProPublica map locates Kentucky dialysis facilities with dark blue dots; gray areas are lakes and national forests)

Last year, a ProPublica investigation showed inferior care and little oversight in some facilities. Officials with the Centers for Medicare and Medicaid Services told Sen. Charles Grassley, R-Iowa, they are now making public their statistical compilations on the country's 5,000 dialysis clinics. This has never been done before, though CMS "has used public money to collect and analyze the data in the reports for more than a decade," Fields reports. CMS is planning on posting the reports on Medicare's Dialysis Facility Compare website. ProPublica has already posted those reports, which can be viewed by clicking here.

ProPublica's investigation reviewed eight years of inspection records for more than 1,500 clinics and "turned up hundreds of lapses in care, some of which led to patient injuries and death," Fields reports. It also found hundreds of clinics had not been inspected for five years or more, though they are supposed to be checked every three years. Upon learning of the investigation, Grassley asked CMS about what it was doing to improve things.

CMS officials conceded that inspections were inadequate in more than a third of the states. Tougher standards had reportedly been implemented to make the inspections more comprehensive; they are apparently needed. In the past two fiscal years, 15 percent of facilities inspected had "deficiencies serious enough to warrant termination from the Medicare program if left uncorrected," Fields said. (Read more)

People with low health literacy are more likely to get sick, die

Health literacy rates are increasingly gaining the attention of providers, organizations and lawmakers. A new report based on study of medical literature says people who are unable to understand and act on issues related to their own health care have poorer health and a higher risk of death.

Adults with low health literacy are less likely to get a flu shot, understand medical labels and instructions, and have a greater likelihood of taking medicine incorrectly, the report says. Also, women with low health literacy are less likely to get mammograms. Overall, the report indicates that minorities have lower health literacy rates than the rest of the population.

More than 75 million English-speaking adults across the nation have difficulty understanding and using basic health information. That was the focus of the second annual Kentucky Health Literacy Summit last week.

The report, which was released Monday, updates 2004 literature that reviewed the findings of more than 100 studies. It was compiled by the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services.

In May 2010, the department launched an action plan that asks stakeholders to simplify their health-related handouts, forms and websites by removing jargon and complicated explanations. It also calls for improving patient-provider communication. (Read more)

Annual county health rankings will be released Wednesday

The national County Health Rankings for 2011 will be released Wednesday, March 30. The rankings give a snapshot view of every county in the nation by examining factors such as rates of obesity, smoking, uninsured adults and various diseases.

The Robert Wood Johnson Foundation will host a live teleconference that day to brief news media about the data. Speakers will include James Marks, senior vice president and director of the Health Group at the RWJF; project director Patrick Remington, associate dean for public health at the University of Wisconsin; and Joe Reardon, mayor of Kansas City, Kan.

The conference will be held from 10 to 11 a.m. EDT. For free registration, click here. To view the County Health Rankings for 2010, click here. The rankings are used to produce a county-by-county Health Outcomes Map for each state. Here is Kentucky's for last year; for an interactive version, which enables county-by-county information, click anywhere on the map.

New website, www.SortingThroughTheSmoke.com, offers journalists local and state information on tobacco and health

Three Kentucky organizations are launching a website to serve as a one-stop shop for journalists covering tobacco and health issues in Kentucky, and for others interested in documenting the impact of Kentucky’s tobacco use on the health of the state's residents.

SortingThroughTheSmoke.com is administered by Kentucky Youth Advocates with assistance from the Institute for Rural Journalism and Community Issues and the Kentucky Center for Smoke-free Policy, both based at the University of Kentucky. The site provides state and county-level data, contact information for local and state experts, local and regional news coverage of the issues, and other resources to help tell the story behind tobacco and health in Kentucky.

The site is funded by the American Legacy Foundation, created with money from the 1998 settlement between states and cigarette manufacturers. It carries the same name as a series of 2009 workshops funded by the foundation and conducted by the Institute for Rural Journalism and Community Issues for Kentucky Youth Advocates. On the hot topic of smoking bans, it includes links to information from supporters of regulation and those who favor a libertarian, free-market approach.

Well-being index gives rankings for Kentucky's congressional districts and metropolitan areas; some are very bad

In keeping with its second-to-last state ranking in the 2010 Gallup-Healthways Well-Being Index, which assessed people's physical and emotional health across the country, one of Kentucky's congressional districts and its major metropolitan area have also ranked low.

Of 436 congressional districts nationwide, Kentucky's 5th District ranked 435th overall, and was dead last in the emotional-health and physical-health categories. The other districts' rankings were: 1st, 383rd; 2nd, 404th; 3rd, 312th; 4th, 415th and the 6th, 388th. Here's a table with breakouts and the 2009 rankings:

Of the 188 metropolitan areas assessed, Louisville ranked 170th, not much different from its 151st ranking in 2009. Lexington ranked 115th, way down from 15th. Among metro areas centered in other states, Cincinnati was 123rd; Clarksville, Tenn., was 162nd; Evansville was 172nd; and Huntington was 188th, dead last in the nation. It has scored poorly on several other health measurements.



The well-being index assessed respondents on their emotional health, physical health, life evaluation, work environment, healthy behaviors and basic access. Respondents answered a large spectrum of questions that pertained to their life now and how they expect it to be in five years. In the emotional-health category, for example, they were asked about how often they laugh, if they were treated with respect and if they experienced sadness, anger or depression. In the work-environment category, people were asked about how they are treated by their supervisor, if they are able to use their strengths while at work and if they're satisfied with their job.

Compared to the rest of the country, Kentucky as a whole ranked 49th, surpassing only West Virginia. Hawaii had the highest well-being index in the country.

It bears noting that the rankings are based on very narrow margins of difference, with many states' scores just a few tenths of 1 percentage point apart. While Kentucky's overall well-being index was 61.9 out of a possible 100 points, Hawaii, which ranked first in the country, had a score of 71. The 2010 score for the nation was 66.8. West Virginia's score was 61.7 points. Because the scores were so close together, precise rankings are uncertain. The ranges for congressional districts and cities are greater, but the error margins are larger.

The survey was based on random-digit dial telephone interviews with 352,840 adult Americans living in all 50 states and the District of Columbia. There were 5,881 Kentuckians who participated in the study. Of those, 1,046 live in the 5th Congressional District and 1,632 live in the Louisville area, which includes Jefferson County and the Indiana border. Interviews were conducted every day from January to December 2010.

The margin of sampling error for most states is plus or minus 1 to 2 percent, but is as high as plus or minus 4 percent for the smallest states. For results based on the total sample size, "one can say with 95 percent confidence that the maximum margin of sampling error is plus or minus 1 percentage point," says Elizabeth Mendes of Gallup.