Measured by rates of violent death, the most dangerous counties in the United States have rates that are more than 10 times higher than the safest counties.
As you can see in the map below, rates vary from less than 10 to more than 100 violent deaths per 100,000 population, based on homicides, police shootings, and suicides in the years 2004 through 2010. (Counties with rates based on 20 or fewer deaths are unreliable and are marked as suppressed.)
I generated this map and the others below using WISQARS (Web-based Injury Statistics Query and Reporting System), an interactive database system that provides customized reports of injury-related data collected by the Centers for Disease Control and Prevention. The mapping module draws on seven years of data, the amount needed to produce reliable county-level injury-related death rates, according to the CDC, and it is a powerful tool to explore health disparities. Continue reading
AHCJ has just updated its easy-to-use Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey data to include the latest release of the data by the U.S. Centers for Medicare and Medicaid Services and reflect changes in the data by CMS.
The data include survey questions about how doctors and nurses communicate, how hospitals are controlling patients’ pain, how hospitals are keeping clean and quiet, and more. AHCJ also creates a spreadsheet file that contains a timeline of the overall ratings of hospitals, with results from October 2006 to September 2013.
Each data release now includes the beginning and ending dates covered in the survey. The latest hospital survey results cover Oct. 1, 2012, through Sept. 30, 2013.
Here’s a resource for health care costs – and a creative journalistic model of crowdsourcing, data collection, mapping, reporting and blogging.
ClearHealthCosts.com was started by former New York Times reporter and editor Jeanne Pinder. She received start-up funding from foundations (Tow-Knight Center for Entrepreneurial Journalism at CUNY and others listed on the website) and ClearHealthCosts now has a team of reporters and data wranglers chipping away at some of the difficult questions that patients need answered: How much is this treatment going to cost me? Can I find a better price?
It’s about shedding light on a health care cost and payment system that, to use Pinder’s word, is “opaque.” Some of what they are doing is specific to a half-dozen cities; other projects are building out nationally.
The data collected by ClearHealthCosts focuses on elective or at least nonemergency procedures such as imaging, dental work, vasectomy, walk-in clinics, screening (mammograms and colonoscopy) and blood tests. Much of the data is crowdsourced, and focused on New York area, including northern New Jersey and other suburbs; the San Francisco and Los Angeles areas; and Houston, Dallas-Fort Worth, Austin and San Antonio in Texas.
A recent grant from the John S. and James L. Knight Foundation via its Prototype Fund will let ClearHealthCosts collaborate with KQED in San Francisco and KPCC/Southern California Public Radio in Los Angeles to crowdsource Califoria prices. Earlier, Pinder’s team did a crowdsourcing partnership with the Brian Lehrer Show at WNYC public radio in which hundreds of women shared mammogram payment information, and their thoughts. It led to a series of blog posts including here and here. Continue reading
Last week, I encountered yet another example of why it’s so important to always read the whole study — not just the press release. In this case, it was actually a report, not a study. A press release from Alzheimer’s International with the somewhat misleading headline, “Smoking Increases Risk Of Dementia” arrived in my inbox, citing a new World Health Organization report that put smokers at a 45% higher risk for developing the disease than non-smokers.
When I opened the report, I learned that the “news” touted in the press release was actually just a summary of old research. There was nothing new here. Nor was there proof of causation – the cited evidence showed associations.
As I looked more closely at the report, I found an error that appeared to undermine its conclusions and suggest a sloppiness and lack of rigor.
We posted some data tools from the Robert Wood Johnson Foundation for the health reform beat and AHCJ’s New York chapter recently got to hear about them in more detail with some help from RWJF. If you’ve done stories using this data, we’d love to see them and learn about how you used the data. Send them to email@example.com.
Charles Ornstein Storyfied the meeting and we have this guide for you from RWJF. Continue reading
Every year, the Centers for Medicare & Medicaid issues a list of troubled nursing homes as part of its Special Focus Facility Initiative. CMS released an updated list on June 19 as a PDF and AHCJ has posted the list as a series of web pages and has made them available to download as Excel spreadsheets.
The initiative is intended to address nursing homes that cycle in and out of compliance. Homes in this program are visited by survey teams twice as frequently as other nursing homes. This list includes nursing homes added to the SFF initiative and updates the status of homes already in the program.
This year, 15 homes in 14 states were added to the list. Sixteen others were found to have “failed to show significant improvement,” 23 were deemed to have shown improvement, 33 have “graduated” from the program and four are no longer participating in Medicare/Medicaid.
Angelo Fichera of The Philadelphia Inquirer recently reported on one nursing home that will likely close after spending three years in the SFF Initiative, noting that CMS has not seen an improvement in care:
CMS expects that after two years on the watch list, nursing homes will either improve and “graduate” from the program; have funding terminated; or be granted an extension to improve because of “promising progress,” according to the agency.
To round out your reporting on nursing homes, AHCJ just updated its version of CMS’s Nursing Home Compare database, which includes details of the most severe deficiencies found during nursing home inspections for the past three years. AHCJ posted separate files covering the star ratings for nursing homes – from 1 to 5 – based on quality, inspection results, staffing and overall ratings.
While beauticians and tattoo artists are regulated in the state of Oregon, midwife certification is voluntary and, even then, the hurdles for certification are rather minimal.
But with midwives largely operating outside of the established health care system, there was little more than anecdotal evidence about the safety of home births to go on. That changed last year.
Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin and an AHCJ Regional Health Journalism Fellow, describes how he took advantage of new data collected by the state of Oregon to shape an article that revealed high mortality rates for home births in his state.
“If home birth were a drug,” he wrote, “it would be taken off the market.”
Read more about how he reported the story and get links to resources he used.
With the Centers for Medicare & Medicaid Services release of new data showing what hospitals across the country charge Medicare for the same treatment or procedure in 2012, AHJC has gone a step further to help members compare hospitals from one year to the next.
CMS released data files that include bills submitted by 3,500 hospitals for the 100 most commonly performed inpatient conditions in 2011 and 2012. This allows a basis for some local or regional comparisons and a starting point for stories on hospital costs and services.
AHCJ combined the two files to include the hospital name and location, the number of patients with the specific conditions discharged, hospital charges and the amount paid to the hospital for both years. The file covers only inpatient charges. Members can download the file here and read details about each data element, links to other documentation, and how the datasets differ from one year to the next. Not every hospital will be listed for every top 100 condition. If the hospital records 10 or fewer discharges, CMS excludes those numbers because of privacy concerns.
In addition to comparing costs, reporters can see if local hospitals have increased or decreased the treatment of specific conditions. Those changes might indicate changes in local physician population, changes in community needs, opening or closing of hospital services, or even hospital marketing efforts.
Recently, Dr. Ben Goldacre (@bengoldacre), a prominent critic of drug studies, wanted to find out how often side effects reported by users of cholesterol-lowering drugs called statins were genuinely caused by the medications.
The study he co-authored concluded that most reported side effects of statins aren’t often due to the drugs themselves, but to other causes. The study generated front-page headlines in the U.K., with an article in The Telegraph declaring, “Statins have virtually no side effects, study finds.”
Outcry ensued. Patients who experienced side effects on statins begged to differ, and Goldacre’s fans wondered if he had suddenly gone soft on pharmaceutical companies.
In response, Goldacre penned a nuanced explanation of the study findings, explaining* that its conclusions were flawed because it was based on incomplete data.
The statin study controversy aside, his blog post makes some key points about how side effects are reported in medical journals that are helpful for health reporters to keep in mind when covering the downsides of new drugs. I’ve boiled some important points down and included them in this tip sheet for AHCJ members.
*Editor’s note: An earlier version of this post used the word “admitting.”
Image by Ray Dumas via flickr.
There was some good data analysis that turned personal for me last week, and I feel compelled to give a shout-out to the reporters and publications (Consumer Reports, CNN, Time) that covered the stunning rise in cesarean rates in the U.S. and revealed the enormous differences in C-section rates between hospitals.
This is really helpful stuff if you’re trying to find the best place to deliver a baby, as I’ve been for the past few weeks. And trust me, it’s no easy task.
I’m pregnant with my first child. As a health reporter, all the worries of pregnancy have been compounded by what I’ve long known about the health care system I’m up against.
The U.S. is a scary place to be expecting a baby. We spend more than any other country in the world on health care and more on childbirth related care – $86 billion annually – than on any other area of hospitalization, according to a 2011 editorial in the journal Contraception. Yet our maternal-fetal outcomes are some of the worst among developed nations.