The Hospital 2
Background: In March 2010, 13-valent pneumococcal conjugate vaccine (PCV13) replaced the seven-valent vaccine in the USA. We assessed the effect of PCV13 use on pneumococcus-related admissions to hospital 2 years after the vaccine was introduced, when coverage in children younger than age 5 years had reached 54%.
The Hospital 2
Methods: We used data from a private inpatient discharge record database. We extracted age-specific data for admissions to hospital per month (July 1-June 30) for all-cause pneumonia, invasive pneumococcal disease, non-invasive pneumococcal pneumonia, and empyema (all coded by International Classification of Diseases 9) for 2005-12. We also extracted data for urinary tract infection and hospital admission for any reason as control outcomes. We assessed incidences of hospital admission before and after the introduction of PCV13 and used a negative binomial multiple regression model to estimate how much of the change in hospital admissions could be attributed to the vaccine.
Findings: Our model results showed that PCV13 was associated with significant reductions in hospital admissions for all-cause pneumonia for some children (21% [95% CI 14-28] in children aged
Interpretation: Only 2 years into the US programme, PCV13 significantly reduced residual invasive and non-invasive pneumococcal hospital admissions in children younger than 5 years, as well as in some adult age groups. Our study design captured the total prevented hospital burden (directly and indirectly by herd protection) and also showed a reversal of the PCV7 era increase in paediatric empyema related to strain replacement.
As time went by, Fort McHenry became less a receiving hospital and more a surgical center. Army doctors, working with local medical schools and hospitals, developed many new surgical techniques. Much medical history was made here, particularly in neuro-surgery. Great advances were made in plastic surgery as well. Soldiers who had lost portions of their faces left the hospital with new noses, new ears, and other miraculous results of the then new surgical techniques. Facial reconstruction surgeries, as they were called, would allow these soldiers to have as close to a normal life as possible after suffering such gruesome injuries.
On June 14, 1922, the patients and hospital personnel were treated with a visit by their Commander-in-Chief, President Warren G. Harding. He was at the Fort on this special Flag Day to dedicate the newly erected statue of Orpheus, a memorial to Francis Scott Key and the defenders of Baltimore in 1814. The statue can be seen at the park today.
The Hospital2Home program is a voucher program for those eligible who are being discharged from hospital to home. Vouchers allow for the purchase of short-term services such as personal care and home-delivered meals to assist individuals returning to their homes after a brief hospital stay. The program will also offer short-term telephonic assistance to help with redeeming the vouchers if necessary and assist in the exploration of ongoing long-term services and supports.
Hospital 2 Home is a collaboration between Meals on Wheels for Greater Houston and medical providers, in which we deliver meals on a short-term basis to recently discharged hospital patients. Our drivers are trained to ask these patients health-related questions, with information communicated back to their healthcare providers. The program has reduced hospital re-admission, particularly among vulnerable population, and improved health outcomes.
Photograph of General Hospital #2, a hospital for African-Americans once located just north of the intersection of 22nd Street and McCoy Avenue (now Kenwood Avenue). This vantage point faces west towards the two main wings of the hospital. Captioned: "Old City Hospital, as the above building is best known, has been General Hospital No. 2, for the care of Negroes, since 1908. Previous to the building of General Hospital No. 1, it was the city's one hospital. In 1914 its personnel became Negro and it has continued to be operated by race professional men and nurses. The north wing of the building is to be cut off from the remainder by a brick wall, and will be the isolation hospital for Negroes, replacing the frame structure used hitherto."
Several dead bodies are discovered in a building by paranormal investigator, Scott (Scott Tepperman) and after he calls it in to the police, he is arrested for the murders. The bodies that were found were people the police had been looking for, but there are still others who are missing. Five years later, Skye (Betsy Rue) and Beth (Constance Medrano) see in the news that Scott has been released from prison. Beth thinks the serial killer Stanley and a couple of other serial killers/rapists are still on the loose, but Skye thinks they are dead, even though their bodies have never been found. Their friend Mandy (Lara-Louisa Piacquadio) asks them to tell her about the case they were working on five years ago before the murders happened. Beth tells Mandy that she was doing a paper on folklore and went to an old hospital to investigate and was held hostage and raped by Stanley. Skye was also there doing a ghost hunt and describes the rape and torture of other girls, and says she thinks it was satanic. Skye and Beth became friends after surviving the incident.
When a Medicare beneficiary arrives at a hospital in need of medical or surgical care, the physician or other qualified practitioner must decide whether to admit the beneficiary as an inpatient or treat him or her as an outpatient. These decisions have significant implications for hospital payment and beneficiary cost sharing. Not all care provided in a hospital setting is appropriate for inpatient, Part A payment.
To address both of these issues, hospitals and other stakeholders requested additional clarity regarding when an inpatient admission is payable under Medicare Part A. In response, in 2012, CMS solicited feedback on possible criteria that could be used to determine when inpatient admission is reasonable and necessary for purposes of payment under Medicare Part A.
To provide greater clarity to hospital and physician stakeholders, and to address the higher frequency of beneficiaries being treated as hospital outpatients for extended periods of time, CMS adopted the Two-Midnight rule for admissions beginning on or after October 1, 2013. This rule established Medicare payment policy regarding the benchmark criteria to use when determining whether inpatient admission is reasonable and necessary for purposes of payment under Medicare Part A.
The Two-Midnight rule also specified that all treatment decisions for beneficiaries were based on the medical judgment of physicians and other qualified practitioners. The Two-Midnight rule did not prevent the physician from providing any service at any hospital, regardless of the expected duration of the service.
Following the adoption of the Two-Midnight rule, CMS received extensive feedback from the stakeholder community, including concerns that the new policy was impacting physician and hospital practices.
The proposed changes to the Two-Midnight rule reflected extensive stakeholder input, from hospitals, physicians, the Medicare Payment Advisory Commission (MedPAC), beneficiary advocates, Congress, and others.
CMS also received important information from the Probe and Educate process conducted by the Medicare Administrative Contractors (MACs), in which CMS contractors have worked with hospitals to clarify the parameters of Medicare payment policy with regard to inpatient and outpatient patient status.
As we considered changes to this rule, CMS sought to balance multiple goals, including: continuing to respect the judgment of physicians; supporting high quality care for Medicare beneficiaries; providing clear guidelines for hospitals and doctors; and providing incentives for efficient care to protect the Medicare trust funds.
BFCC-QIO reviews of short inpatient hospital claims focus on educating doctors and hospitals about the Part A payment policy for inpatient admissions. BFCC-QIOs will refer providers to the Recovery Auditors based on patterns of practices, such as high rates of claims denial after medical review or failure to improve after QIO assistance has been rendered. Accordingly, we do not expect substantial Recovery Auditor medical review activity for such claims for several months.
The hospital was a three storied, A-roofed building on the south side Cary Street at the southwest corner of 7th Street. Dr. James M. Holloway was in charge.From Confederate Military Hospitals in Richmond by Robert W. Waitt, Jr., Official Publication #22 Richmond Civil War Centennial committee, Richmond, Virginia 1964.)
The Hospital 2 Home resource is designed to make it easier for health and social care professionals involved in hospital discharge to support older patients in returning home safely after a hospital stay and reduce the risk of readmission to hospital.
Chronic obstructive lung disease ranked sixth, with nearly half a million hospital admissions. This was followed closely by stroke and irregular heartbeat, each with over 400,000 admissions through the ED. Complications of procedures, devices, implants, and grafts ranked as the ninth most common reason for admission through the ED, with over 400,000 cases and included postoperative infections, malfunction of orthopedic devices (e.g., hip replacements that had worn out), and infection of arteriovenous fistulas used for dialysis. Mood disorders were number 10, with nearly 390,000 cases admitted through the ED.
HCUP is based on data from community hospitals, defined as short-term, non-Federal, general, and other hospitals, excluding hospital units of other institutions (e.g., prisons). HCUP data include OB-GYN, ENT, orthopedic, cancer, pediatric, public, and academic medical hospitals. They exclude long-term care, rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals, but these types of discharges are included if they are from community hospitals. 041b061a72