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September 17, 2007

Truck Accidents Rising Along I-70

A few years ago, traffic on Interstate-70 heading from Denver to the mountains was particularly heavy during the ski season as front-range ski enthusiasts headed up for the day. But with the increase in summer tourism and those day-trippers seeking the golden aspens of autumn, traffic is heavy year-round. Average daily traffic at the Eisenhower Tunnel increased 7 percent from 2004 to 2006, according to CDOT.

stuckcar.jpgThis makes the number of truck-related accidents a particular concern along this stretch of interstate. The number of truck accidents that shut down I-70 in Summit and Clear Creek counties have more than doubled over the past three years, according to the Colorado Department of Transportation. There were 151 incidents between September 2006 and April 2007 involving tractor-trailers - jackknifed trucks, truck crashes, trucks without chains - that resulted in all or part of I-70 being closed. The closures lasted the equivalent of 5 1/2 days, or 130 hours.

Those numbers compare with 60 incidents involving tractor- trailers resulting in highway closures for 61 hours, or 2 1/2 days, during the same eight-month period in 2004-2005. This is due in part to the rise in commercial freight traffic nationwide.

The CDOT analysis of highway closure data has prompted plans for seven new state troopers to patrol the busy stretch of highway this snow season and expectations that new chain laws will help curb the trend. New chain laws that went into effect at the beginning of this month toughen penalties and require all commercial vehicles to carry chains when traveling I-70 between Edwards and Golden from September through May.

Weather and speeding remain critical factors in mountain crashes and other highway-closing incidents.

Tractor-trailer-related incidents weren't the only cause for closures in the popular stretch of I-70. Personal motor vehicle crashes along I-70 in Summit and Clear Creek counties climbed 60 percent over three years, from 58 from September 2004 through April 2005 to 93 for that same period ending in 2007. The motor vehicle wrecks resulted in all or part of the highway being closed for 163 hours last year, up from 109 hours two years earlier.

The overall result is I-70 was either entirely or partially closed in Clear Creek and Summit counties for 374 hours last year - or the equivalent of 15 1/2 days.

For not carrying chains is $50, plus a surcharge; for not chaining up when the chain law is in effect is $500 (up from $100), with a surcharge; for not chaining up and subsequently blocking the highway is $1,000 (up from $500), plus a surcharge. The new surcharges have not yet been determined.

September 7, 2007

Hospital Transparency - No, Not the Gown

The New York City Health and Hospitals Corporation, the nation’s largest public health system, will voluntarily make public infection and death rates at the eleven hospitals within its system. The city hospitals, which serve 1.3 million patients annually, are far ahead of the industry, health care experts and consumer advocates said. The information on the safety and performance of its hospitals will be posted on a new Web site, which will be accessible to the public on Friday. The new Web site will provide information on statistics such as the rate of deaths after heart attacks and preventable bloodstream infections by hospital.

hospitalgown.jpgThe federal Centers for Disease Control and Prevention projected this year that 1.7 million patients would get an infection during a hospital stay and that of those, 99,000, or 270 per day, would die. The Centers estimates the cost of the infections at more than $30 billion annually.

In 19 states, hospitals are required to report some level of information to the public about hospital-acquired conditions, ranging from bloodstream infections to bedsores.

Colorado Requires Hospital Reporting

In June 2006, House Bill 1045, which requires the analysis and reporting of infection data by health care facilities, and House Bill 1278, which creates what is known as the Colorado Hospital Report Card, were signed into law. With the information obtained through the Colorado Hospital Report Card Act, a website has been created where everyone can easily access the data, Colorado Hospital Quality.

The website provides eleven risk-adjusted mortality indicators. Inpatient Quality Indicators for Colorado Hospitals provide consumers performance measures for eleven risk-adjusted mortality (death) indicators and four volume indicators for all Colorado full-service hospitals. The data used for these reports comes from information hospitals record primarily for billing purposes. The records, referred to as "administrative data," consist of diagnoses and procedures, along with information about the patient's age, gender, accompanying medical conditions and discharge status.

Did Your Homework on the Hospital, Now Which Doc?

You may have information as to the choice of local hospitals, bu there remains the problem for patients in choosing a physician. Now a court ruling appears to open the way for consumer access to such information for the first time, last week a federal judge in Washington, D.C., ruled in favor of a consumer group that sued the Health and Human Services Department to allow disclosure of specific data about doctors from the Medicare claims database.

U.S. District Judge Emmet G. Sullivan concluded that releasing the data would be "a significant public benefit," and ordered the department to turn it over by Sept. 21.

With information on more than 40 million patients and 700,000 doctors, the Medicare database is far richer than any private insurer's. Though it does not have information on some doctors, such as pediatricians, who don't treat Medicare patients, it is considered the mother lode for data on those who treat adults, because Medicare recipients are a mainstay of most practices.

The database's usefulness has been limited by a decades-old government policy that protects the privacy of doctors, who fear the information could be used to micromanage the practice of medicine. But as the cost of medical care has skyrocketed, employers, insurers and consumer groups have pressured the government to open up Medicare's files on individual doctors. The data could be analyzed to determine how a doctor makes crucial decisions on tests and procedures that determine both quality and costs. They would show which doctors fail to order prudent preventive tests. And they could indicate which ones order duplicative tests or unnecessary hospitalizations.

The Department of Health and Human Services has not decided whether to appeal the ruling. An appeal could be politically embarrassing for the administration, because President Bush and Health and Human Services Secretary Mike Leavitt have both campaigned for greater openness and consumer empowerment in healthcare.


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