Hospital, Dignity, Reality

[vitanola]

He holds both positions. What is your point?

Gee, like politico is not biased. :rofl:

It is not political if the statistics are correxct and they are. He didn't get the statistics himself. They came from an external source. Did you read the entire book and check the footnotes? Obviously not.

Wel, Politico DOES lean a bit to the right...

I suppose that you would find Newsmax, Breitbart, or Drudge to all be part of "The Liberal Media Conspiracy".

You posted an article ( or book) that was written with the intention of becoming a political polemic here, in a non- political discussion board.



As for reading his book, have you, yet?

Your post appeared tp have been derived from one of Dr. Atlas's political advocacy articles. In point of fact I thought that it was the article that I came across in Forbes some time ago, "The Liberal Media's Erronious Indictment of U. S. Health Care". I'll be picking up a copy of the boook at our local college library tomorrow. No doubt that they will have one, as Dr. Atlas has visited with some frequency for strategic planning sessions which are held under the school's auspicies.

 

[AmateisGal]

Uh oh. We are starting to devolve into politics. (And Breitbart and Drudge are most definitely conservative-slanted, so I'm not sure what you're talking about them belonging to the "liberal media conspiracy").

Anyway, my experiences at my hospital where I live now (I've been "fortunate" enough to have three surgeries in the last two years), have been excellent. No complaints from me at all. I was treated kindly, and if I had needs, they were responded to promptly.

I really think it depends on what part of the country you're in as to how your medical care is.

Now the hospital 450 miles away from me in my hometown is a disgrace. Horror stories abound there.

 

[Wesley Milton Dagwell]

I had my first stay in a hospital this year, it was just overnight. Everyone was nice, food surprisingly good, though I did not hold on to it for very long! The only beef I really had was communication between staff. Everyone told me something different and left me unsure what was happening. Next time I will be grilling everyone I see.

 

[Baron Kurtz]

Yes, the communication was irritating. First thing into the ER, a drip was applied. Someone came and "turned up" the rate of drip, then someone else turned it down, then yet another cap turned it up again, but too far, then finally a doctor came along and turned it down.

When the Baroness was admitted, we twigged quite early that they would change a drip when only 1/4 of it had been used. You can be damn sure we were being charged massive amounts for full drips every time! When pointed out, it was described as "policy", but the practice mysteriously stopped when it was clear they'd been rumbled. Same deal with trying to foist more and more painkillers.

The whole experience was one of inexorable scheming and grasping for cash from the hospital. The staff had quite obviously been trained to within an inch of their life to scam as much as possible to ensure maximum use of pay-to-use facilities and consumables.

 

[jamespowers]

This is absolutely *not* universally true. In the U.S., we do not typically employ life saving procedures until the infant is 23-24 weeks from the mother's LMP, even if the baby is born alive. This is called the "viability" date, despite a low survival rate. The practices vary by state, in my state it is 24 weeks and that is the recommended procedure that my OBs follow and my local level 4 NICU follows. My insurance will not cover a baby's NICU stay that is born before 24 weeks. I know this personally because it's relevant to me.

The survival rate under 24 weeks is only about 10% at best even if they decided to try. Although there have been exceptions to this, most of them are because the doctor's mistakenly thought the mother was further along. Technically, in this country, any birth considered before 24 weeks but after 20 is a late miscarriage if they don't intervene.

And you just made my point. We try like heck to save babies whenever they are born.

 

[kiwilrdg]

When the Baroness was admitted, we twigged quite early that they would change a drip when only 1/4 of it had been used. You can be damn sure we were being charged massive amounts for full drips every time! When pointed out, it was described as "policy", but the practice mysteriously stopped when it was clear they'd been rumbled.

That is one possibility. Another possibility might be they replace the bag early to ensure it does not go empty, filling the needle with blood that clots and clogs the line. Once they knew you were monitoring the status they felt comfortable to let it run.

Either scenario is about as likely as the other to be the case.

 

[jamespowers]

You posted an article ( or book) that was written with the intention of becoming a political polemic here, in a non- political discussion board.



As for reading his book, have you, yet?

Your post appeared tp have been derived from one of Dr. Atlas's political advocacy articles. In point of fact I thought that it was the article that I came across in Forbes some time ago, "The Liberal Media's Erronious Indictment of U. S. Health Care". I'll be picking up a copy of the boook at our local college library tomorrow. No doubt that they will have one, as Dr. Atlas has visited with some frequency for strategic planning sessions which are held under the school's auspicies.

Those ten points are NOT political. Statistics have meaning---no matter what you would rather have them say.

Yes, I have read the ENTIRE book.

It was not derived from an article by Dr. Atlas. Nothing more. The statistics are there for anyone who wants to look at them. Hillsdale should have the book along with plenty of other good reading.

Now back to Dignity and REALITY.

 

[sheeplady]

Yes, the communication was irritating. First thing into the ER, a drip was applied. Someone came and "turned up" the rate of drip, then someone else turned it down, then yet another cap turned it up again, but too far, then finally a doctor came along and turned it down.

When the Baroness was admitted, we twigged quite early that they would change a drip when only 1/4 of it had been used. You can be damn sure we were being charged massive amounts for full drips every time! When pointed out, it was described as "policy", but the practice mysteriously stopped when it was clear they'd been rumbled. Same deal with trying to foist more and more painkillers.

The whole experience was one of inexorable scheming and grasping for cash from the hospital. The staff had quite obviously been trained to within an inch of their life to scam as much as possible to ensure maximum use of pay-to-use facilities and consumables.

My grandmother was in the hospital for 88 days before she died. (Not where I live now.) Interestingly enough, there are limits on how long Medicare will pay for a hospital stay for a condition if there is improvement. Each time she hit one of these limits, her diagnosis changed until that time period ran out. At one point, they refused to treat her for a high fever because she had a day left on her previous diagnosis. A nurse actually told my family that the doctor was refusing to come see her until the next day because of it and that we should look up the time limits and request my grandmother's records.

My grandfather was told to sue the hospital, but he wasn't interested.

 

[sheeplady]

And you just made my point. We try like heck to save babies whenever they are born.

You can't argue that our healthcare system is somehow better because we try to save earlier babies than the rest of the world and you also can't argue that our infant mortality rate is higher because we try to save earlier babies than the rest of the world; *because most of the developed world is trying to save 24 weekers the same as in the US.* And heck, some of those countries do better at actually saving the infants born earlier than we do!

Plenty of parents of babies who are 23 weeks and 6 days who were born alive would argue with your point that we try like heck to save babies whenever they are born- we have a cut off- so does the rest of the world.

Our preterm birth rates in the US have actually gone up in the past several years. This should be disturbing.

 

[jamespowers]

You can't argue that our healthcare system is somehow better because we try to save earlier babies than the rest of the world and you also can't argue that our infant mortality rate is higher because we try to save earlier babies than the rest of the world; *because most of the developed world is trying to save 24 weekers the same as in the US.* And heck, some of those countries do better at actually saving the infants born earlier than we do!

Plenty of parents of babies who are 23 weeks and 6 days who were born alive would argue with your point that we try like heck to save babies whenever they are born- we have a cut off- so does the rest of the world.

Our preterm birth rates in the US have actually gone up in the past several years. This should be disturbing.

Until you can come up with some numbers, with sources, to prove that then we are done.

 

[Baron Kurtz]

jp, while I love your floods of data (an interesting obfuscatory tactic, well done), I'm trying to understand the uses here of percentages, and particularly those higher than 100.

When the author states that survival is 52% higher in the US, does he mean, for example that a survival rate was literally 52% higher in one country than another? So, 10% in one country and 62% survival in another. This would truly be shocking. I simply don't believe it, and don't think you can find facts to prove it, given that the survival rates tend to be around the 35-50% rate for most cancers but range greatly. Here's some data from CRUK (modelled so not perfect, but illustrative of general survival rates):

http://www.cancerresearchuk.org/cancer-info/cancerstats/survival/latestrates/survival-statistics-for-the-most-common-cancers

When the author states that "Prostate cancer mortality is 604 percent higher in the United Kingdom", for example, what does that number mean? What we need here are real numbers. Of X people diagnosed, Y percentage beat it, Y percentage died. 604% is an impossibility.

p.s. the pedant in me wants to point out that you and the author (at least what you've quoted) haven't quoted any facts, just dubious numbers.

This shouldn't be considered a big run one way or the other but facts have a tendency to get in the way of perception:

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

 

[sheeplady]

Until you can come up with some numbers, with sources, to prove that then we are done.

Really? Ok, here goes:

Davidoff, et al. (2006) Changes in the Gestational Age Distribution among U.S. Singleton Births: Impact on Rates of Late Preterm Birth, 1992 to 2002:
Changes in the mean birth rate in the U.S. decreased from 40 weeks to 39 weeks; with a significant rise in births 34 to 39 weeks, with many of those births having high risk complications that led to births before 37 weeks, such as PROM.

Beck, et al. (2010) The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity
"The highest rates of preterm birth were in Africa and North America (11.9% and 10.6% of all births, respectively), and the lowest were in Europe (6.2%)."
"Preterm birth rates available from some developed countries, such as the United Kingdom, the United States and the Scandinavian countries, show a dramatic rise over the past 20 years."

Pignotti & Donzelli (2008) "Perinatal Care at the Threshold of Viability: An International Comparison of Practical Guidelines for the Treatment of Extremely Preterm Births"
"The American Academy of Pediatrics provides suggestions16 for counseling but fails to give any specific recommendations for treatment stratified on gestational age. However, it does not recommend active intervention for infants under 23 weeks or with 400-g birth weight. The American College of Obstetricians and Gynecologists furnishes recommendations17 split into levels concerning counseling and treatment options: maternal transport to a tertiary center before delivery, an individualized treatment decision of the fetus/newborn, and a single course of corticosteroids between 24 and 34 weeks. In the German document,18 the principle outline states that “if there is any chance, it is necessary to do everything to sustain survival,” and regardless of immaturity, every preterm neonate is a candidate for treatment.""
and
"Week 22 to 22 is considered to be the cutoff of human viability: no scientific society recommends performing any kind of active treatment on the mother that is aimed at protecting the fetus or on the newborn except for offering compassionate care. A general agreement is also evident for week 25 to 25: antenatal steroids are recommended, prenatal transport and cesarean section are also indicated to protect the fetus, and resuscitation is offered to all infants without fatal anomalies. More caution is shown in Switzerland, where resuscitation is initiated on an individual basis, and also in the Netherlands, where cesarean section is rarely performed on fetal indication and the option for active treatment is subject to the consideration of the infant's clinical conditions. On the other hand, in Australasia almost all infants of 24 weeks to 24 weeks are candidates for intensive care. From the reviewed guidelines, it seems clear that 23 to 24 weeks are a sort of “gray zone,” where recommendations suggest resuscitation on an “individual basis” and “according to the parents' wishes.” In some countries, this gray zone extends through 25 to 25 weeks."

I am awaiting your stats on how the U.S. intervenes when other countries do not.

 

[Baron Kurtz]

Go Pubmed!

 

[jamespowers]

When the author states that survival is 52% higher in the US, does he mean, for example that a survival rate was literally 52% higher in one country than another? So, 10% in one country and 62% survival in another. This would truly be shocking. I simply don't believe it, and don't think you can find facts to prove it, given that the survival rates tend to be around the 35-50% rate for most cancers but range greatly. Here's some data from CRUK:

http://www.cancerresearchuk.org/can...rvival-statistics-for-the-most-common-cancers

When the author states that "Prostate cancer mortality is 604 percent higher in the United Kingdom", for example, what does that number mean? What we need here are real numbers. Of X people diagnosed, Y percentage beat it, Y percentage died. 604% is an impossibility.

p.s. the pedant in me wants to point out that you and the author (at least what you've quoted) haven't quoted any facts, just dubious numbers.

It means simply that if you have any kind of common cancer in US then you have a 52% greater chance of survival than the same person in Germany. Period. You cannot use a percentage of a percentage. You have to use numbers. Therefore, they are twice as likely to die of a common form of cancer such as kidney or colon cancer.

I don't have the book at hand at the moment but the simple thing is that if you have prostate cancer in the UK then you have a 604% greater chance of dying from it there than you have of dying from it in the US. You don't need to make it more complicated than it is. In other words, you are six times more likely to die of it where you are than where I am.

 

[sheeplady]

Go Pubmed!

I totally wish there was a like button on the FL!

I love Pub Med, though, it really allows you to be an advocate in your own care in a way you couldn't be before- unless you had access to a really good librarian and a university quality (as far as sources) library.

 

[jamespowers]

Really? Ok, here goes:

Davidoff, et al. (2006) Changes in the Gestational Age Distribution among U.S. Singleton Births: Impact on Rates of Late Preterm Birth, 1992 to 2002:
Changes in the mean birth rate in the U.S. decreased from 40 weeks to 39 weeks; with a significant rise in births 34 to 39 weeks, with many of those births having high risk complications that led to births before 37 weeks, such as PROM.

Beck, et al. (2010) The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity
"The highest rates of preterm birth were in Africa and North America (11.9% and 10.6% of all births, respectively), and the lowest were in Europe (6.2%)."
"Preterm birth rates available from some developed countries, such as the United Kingdom, the United States and the Scandinavian countries, show a dramatic rise over the past 20 years."

Pignotti & Donzelli (2008) "Perinatal Care at the Threshold of Viability: An International Comparison of Practical Guidelines for the Treatment of Extremely Preterm Births"
"The American Academy of Pediatrics provides suggestions16 for counseling but fails to give any specific recommendations for treatment stratified on gestational age. However, it does not recommend active intervention for infants under 23 weeks or with 400-g birth weight. The American College of Obstetricians and Gynecologists furnishes recommendations17 split into levels concerning counseling and treatment options: maternal transport to a tertiary center before delivery, an individualized treatment decision of the fetus/newborn, and a single course of corticosteroids between 24 and 34 weeks. In the German document,18 the principle outline states that “if there is any chance, it is necessary to do everything to sustain survival,” and regardless of immaturity, every preterm neonate is a candidate for treatment.""
and
"Week 22 to 22 is considered to be the cutoff of human viability: no scientific society recommends performing any kind of active treatment on the mother that is aimed at protecting the fetus or on the newborn except for offering compassionate care. A general agreement is also evident for week 25 to 25: antenatal steroids are recommended, prenatal transport and cesarean section are also indicated to protect the fetus, and resuscitation is offered to all infants without fatal anomalies. More caution is shown in Switzerland, where resuscitation is initiated on an individual basis, and also in the Netherlands, where cesarean section is rarely performed on fetal indication and the option for active treatment is subject to the consideration of the infant's clinical conditions. On the other hand, in Australasia almost all infants of 24 weeks to 24 weeks are candidates for intensive care. From the reviewed guidelines, it seems clear that 23 to 24 weeks are a sort of “gray zone,” where recommendations suggest resuscitation on an “individual basis” and “according to the parents' wishes.” In some countries, this gray zone extends through 25 to 25 weeks."

I am awaiting your stats on how the U.S. intervenes when other countries do not.

This is not the place to make a long and boring figure for figure exchange. I could come up with five more excerpts and then you could come up with five more and so on and so on. It accomplishes nothing. Let's just agree to disagree.

 

[kiwilrdg]

Interesting twist to the topic when the OP stated

you feel helpless and vulnerable along with realizing that your just a number.

 

[Baron Kurtz]

Well, 604%, you must admit is impossible. 6.04-times greater is fine; the other way, not so much.

Anyhow, when you get to the book could you PM me his primary references and/or meta-analysis references? As a basic biology of cancer scientist, these kinds of numbers/claims interest me greatly.

It means simply that if you have any kind of common cancer in US then you have a 52% greater chance of survival than the same person in Germany. Period. You cannot use a percentage of a percentage. You have to use numbers. Therefore, they are twice as likely to die of a common form of cancer such as kidney or colon cancer.

I don't have the book at hand at the moment but the simple thing is that if you have prostate cancer in the UK then you have a 604% greater chance of dying from it there than you have of dying from it in the US. You don't need to make it more complicated than it is. In other words, you are six times more likely to die of it where you are than where I am.

 

[jamespowers]

Well, 604%, you must admit is impossible. 6.04-times greater is fine; the other way, not so much.

Anyhow, when you get to the book could you send me his primary references and/or meta-analysis references? A sa cancer researcher, these kinds of numbers/claims interest me greatly.

I think the terms could have been better used by the doctor but 604% is the same thing as 6 times greater. It does confuse though if you think of it as 604%. lol lol

I will do that. The reference list is several pages at the back though. I'll have to sort the ones specifically for cancer. Those greatly interest me as well since just about my whole family died from some form of cancer. Needless to say, I run to the doctor for every lump or bump. lol lol

 

[Baron Kurtz]

Ha!

Interesting twist to the topic when the OP stated

you feel helpless and vulnerable along with realizing that your just a number.

Yup, that's how it goes. Live long enough and either an organ or two will give in, or you'll grow a poisonous one.[huh]

Those greatly interest me as well since just about my whole family died from some form of cancer. Needless to say, I run to the doctor for every lump or bump.