The Observation Deck

“It’s hard to quantify, but no doubt people are suffering every day,” Smedley said, noting that access to health care has become a moral argument -- do we want to be the sole top 10 industiralized nation that provides care only to those who can afford it? Are we willing to let people die for lack of it? -- as well as an economic one.

Bridget Conant wrote:Even with more insured patients under the ACA, energency room use is increasing.

http://www.wsj.com/articles/u-s-emergen ... 1430712061

And here is why:

Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.

All well and good to ask people to see a primary care doctor instead of using an emergency room, but the fact remains that for many, getting in to see a primary care doctor in a timely manner is a challenge. I have seen nothing that indicates this will be changing in the future.

In fact, when the hospital leaves, doctors will follow and there will be fewer primary care doctors with offices in Lakewood. As many of our residents do not have access to vehicles, bus service to Fairview is time consuming, and there is NO bus service to Avon, the difficulty in getting to a primary care appointment is compounded.

I think it's very arrogant to say "if people went to a primary care doctor we wouldn't need an emergency room," just as it is arrogant to say a caregiver should be able to clear an obstructed airway. It would be nice if that were so, but real life gets in the way. People can't get in to see their doctor on short notice and people panic when a child is choking. None of this is going to change so basing your opinion of future ER usage numbers on those examples is inaccurate and dangerous.

Brian Essi wrote:
I would like this communication to be placed in the official City Council records.

Dear Elected Leaders,

I attach a UCSF article for your consideration on the topic that was the subject of City Council's Monday meeting. The information concerning heart attack, stoke and sepsis is of particular concern since I understand that the proposed "ER" will not be able to treat those conditions.

I have taken the following quotes from the article that I find particularly relevant to the point that I was making in my post and to Council:

"In the first analysis of its kind, UC San Francisco research shows that emergency department closures can have a ripple effect on patient outcomes at nearby hospitals."

"In a study of more than 16 million emergency admissions to California hospitals between 1999 and 2010, researchers found that patients who were admitted to facilities located in the vicinity of an emergency department (ED) that had recently closed experienced 5 percent higher odds of dying than patients admitted to hospitals that were not near a recently closed ED."

"The odds of dying were even higher for patients with certain time-sensitive conditions, especially heart attack (15 percent higher odds), stroke (10 percent) and sepsis (8 percent). The findings are of particular concern nationwide, said the authors, because the annual number of ED visits increased by 51 percent between 1996 and 2009, while the number of available emergency departments dropped by 6 percent."

“Our findings indicate that disproportionate numbers of ED closures may be driving up inpatient mortality in communities and hospitals with more minority, Medicaid and low-income patients, and contributing to existing disparities in health outcomes,” said Hsia. “These results suggest that health systems and policy makers should consider the ripple effect on communities when they regulate ED closures.”

https://www.ucsf.edu/news/2014/07/11646 ... ave-closed

The full study can be found at:

http://content.healthaffairs.org/content/33/8/1323.full

May I suggest that the Council President take the subject more seriously in the future and that the folks from Cleveland.com act more responsibly in their future reporting on this very serious subject involving real lives in Lakewood and nearby communities.

In my view, the proposed ""ER" should not be spun into something it is not for political purposes.

I stand by my statement that death has already occurred at Lakewood Hospital--President Madigan as an LHA Trustee is able to verify this without my involvement.

Finally, I would like to give special thanks to Bridget Conant for bringing this study and other valuable information to the debate via her regular posts on the Observation Deck.

Sincerely,

Brian J. Essi

Brian Essi wrote:What has been lost is the fabricated firestorm caused by Blers' in reaction to my provocative "Blood on Your Hands" post is this:

How do Lakewoodites value the lives of our neighbors, especially the most vulnerable among us?

What is the personal responsibility of those neighbors who politicize the issue with false information for their own economic or other interests?

These are provocative questions.

It goes to the heart of a key principle upon which our country was founded: "Love thy Neighbor"

Thanks to Bridget Conant for posting the study and to the Deck, this debate is grounded in scientific study and facts.

Last night I sent the following email to our elected leaders.

I have added bold and size to some quotes from the study.

Please note from the LHA mailer that arrived in your mailboxes this week, that the new "ER" does not include services that would save someone suffering from heart attack or stoke, so the study Bridget brought to our attention squarely points to the critical issue of Love.

From: Brian Essi

Oct 8 at 10:32 PM

ToMike Summers,
Mary Madigan,
Mary Hagan,
Sam O'Leary,
Tom Bullock,
Mary Madigan,
Ryan Nowlin
Cindy Marx,
David Anderson
Shawn Juris

Mrs. Hagan,

I would like this communication to be placed in the official City Council records.

Dear Elected Leaders,

I attach a UCSF article for your consideration on the topic that was the subject of City Council's Monday meeting. The information concerning heart attack, stoke and sepsis is of particular concern since I understand that the proposed "ER" will not be able to treat those conditions.

I have taken the following quotes from the article that I find particularly relevant to the point that I was making in my post and to Council:

"In the first analysis of its kind, UC San Francisco research shows that emergency department closures can have a ripple effect on patient outcomes at nearby hospitals."

"In a study of more than 16 million emergency admissions to California hospitals between 1999 and 2010, researchers found that patients who were admitted to facilities located in the vicinity of an emergency department (ED) that had recently closed experienced 5 percent higher odds of dying than patients admitted to hospitals that were not near a recently closed ED."

"The odds of dying were even higher for patients with certain time-sensitive conditions, especially heart attack (15 percent higher odds), stroke (10 percent) and sepsis (8 percent). The findings are of particular concern nationwide, said the authors, because the annual number of ED visits increased by 51 percent between 1996 and 2009, while the number of available emergency departments dropped by 6 percent."

“Our findings indicate that disproportionate numbers of ED closures may be driving up inpatient mortality in communities and hospitals with more minority, Medicaid and low-income patients, and contributing to existing disparities in health outcomes,” said Hsia. “These results suggest that health systems and policy makers should consider the ripple effect on communities when they regulate ED closures.”

https://www.ucsf.edu/news/2014/07/11646 ... ave-closed

The full study can be found at:

http://content.healthaffairs.org/content/33/8/1323.full

May I suggest that the Council President take the subject more seriously in the future and that the folks from Cleveland.com act more responsibly in their future reporting on this very serious subject involving real lives in Lakewood and nearby communities.

In my view, the proposed ""ER" should not be spun into something it is not for political purposes.

I stand by my statement that death has already occurred at Lakewood Hospital--President Madigan as an LHA Trustee is able to verify this without my involvement.

Finally, I would like to give special thanks to Bridget Conant for bringing this study and other valuable information to the debate via her regular posts on the Observation Deck.

Sincerely,

Brian J. Essi

Brian Essi wrote:

Brian Essi wrote:What has been lost is the fabricated firestorm caused by Blers' in reaction to my provocative "Blood on Your Hands" post is this:

How do Lakewoodites value the lives of our neighbors, especially the most vulnerable among us?

What is the personal responsibility of those neighbors who politicize the issue with false information for their own economic or other interests?

These are provocative questions.

It goes to the heart of a key principle upon which our country was founded: "Love thy Neighbor"

Thanks to Bridget Conant for posting the study and to the Deck, this debate is grounded in scientific study and facts.

Last night I sent the following email to our elected leaders.

I have added bold and size to some quotes from the study.

Please note from the LHA mailer that arrived in your mailboxes this week, that the new "ER" does not include services that would save someone suffering from heart attack or stoke, so the study Bridget brought to our attention squarely points to the critical issue of Love.

From: Brian Essi

Oct 8 at 10:32 PM

ToMike Summers,
Mary Madigan,
Mary Hagan,
Sam O'Leary,
Tom Bullock,
Mary Madigan,
Ryan Nowlin
Cindy Marx,
David Anderson
Shawn Juris

Mrs. Hagan,

I would like this communication to be placed in the official City Council records.

Dear Elected Leaders,

I attach a UCSF article for your consideration on the topic that was the subject of City Council's Monday meeting. The information concerning heart attack, stoke and sepsis is of particular concern since I understand that the proposed "ER" will not be able to treat those conditions.

I have taken the following quotes from the article that I find particularly relevant to the point that I was making in my post and to Council:

"In the first analysis of its kind, UC San Francisco research shows that emergency department closures can have a ripple effect on patient outcomes at nearby hospitals."

"In a study of more than 16 million emergency admissions to California hospitals between 1999 and 2010, researchers found that patients who were admitted to facilities located in the vicinity of an emergency department (ED) that had recently closed experienced 5 percent higher odds of dying than patients admitted to hospitals that were not near a recently closed ED."

"The odds of dying were even higher for patients with certain time-sensitive conditions, especially heart attack (15 percent higher odds), stroke (10 percent) and sepsis (8 percent). The findings are of particular concern nationwide, said the authors, because the annual number of ED visits increased by 51 percent between 1996 and 2009, while the number of available emergency departments dropped by 6 percent."

“Our findings indicate that disproportionate numbers of ED closures may be driving up inpatient mortality in communities and hospitals with more minority, Medicaid and low-income patients, and contributing to existing disparities in health outcomes,” said Hsia. “These results suggest that health systems and policy makers should consider the ripple effect on communities when they regulate ED closures.”

https://www.ucsf.edu/news/2014/07/11646 ... ave-closed

The full study can be found at:

http://content.healthaffairs.org/content/33/8/1323.full

May I suggest that the Council President take the subject more seriously in the future and that the folks from Cleveland.com act more responsibly in their future reporting on this very serious subject involving real lives in Lakewood and nearby communities.

In my view, the proposed ""ER" should not be spun into something it is not for political purposes.

I stand by my statement that death has already occurred at Lakewood Hospital--President Madigan as an LHA Trustee is able to verify this without my involvement.

Finally, I would like to give special thanks to Bridget Conant for bringing this study and other valuable information to the debate via her regular posts on the Observation Deck.

Sincerely,

Brian J. Essi

29 months later and no answer from Tom Bullock (or any other elected official).

People may be dying to vote for him.....if they make it it the polls.