Evidence Shows Sloppy Stroke Care in U.S.

[Conservativesux]

Evidence Shows Sloppy Stroke Care in U.S.

Sat Feb 5, 2005

By MARILYNN MARCHIONE, AP Medical Writer

NEW ORLEANS - Ten years ago, a crucial study proved that a drug could limit the damage from one of nature's biggest train wrecks: a blood clot stuck inside the head. TPA remains the sole drug approved for strokes. Yet only about 3 percent of victims get it.

Usually that's because they don't seek help until it's too late for the drug to do any good — three hours after symptoms start.
However, fresh research documents disturbing problems that keep this lifesaving treatment from reaching the roughly one in five stroke victims who do seek help in time. Studies presented at an American Stroke Association conference last week found that:

_ Operators answering phones at hospitals often don't recognize stroke symptoms and discourage callers from coming in for help.

_ Ambulances routinely take people to the nearest hospital instead of one with the necessary equipment and expertise to give TPA.

_ Emergency room doctors are afraid of the drug's potentially serious side effects, and are unwilling to use it even when test results clearly show they should.

_ Even specialized stroke centers designed to speed the drug to patients are missing many chances to get it right.

"It's like we've built a cascade of system failures here. Every place along the stream is another place something can go wrong," said Dr. Larry Goldstein, director of Duke University Medical Center's stroke program and member of a task force aimed at improving the situation.

More at:
http://story.news.yahoo.com/news?tmpl=story&cid=541&ncid=541&e=2&u=/ap/20050205/ap_on_he_me/sloppy_stroke_care

[VegasWolf]

1. "It's like we've built a cascade of system failures here." Actually,

it's like there was a cascade of special interests all vying
for the same money here doctor.

[Conservativesux]

3. The medical industry actually profits more if the stroke victim..

...is allowed to deteriorate further.

All the $$$ they make from the medications (remember the hospitals that were charging &5.00 for one 250 mg. aspirin pill?), skilled nursing, medical procedures, tests/scans are all lost if the stroke victim makes a full recovery via this medication or any other route.

Its sad to say it but the days of Marcus Welby, M.D. are far behind us and the for-profit medical industry intends to keep it that way :(

[Warpy]

5. You nuts?

TpA is still under patent, and a dose is about $1500 at most hospitals, plus the angio and CT scan. They'd make a bloody fortune treating stroke correctly.

They don't make that much from a deteriorated patients, since Medicare doesn't pay for much long term care and little rehab and Medicaid doesn't pay that much for long term care. Once the deteroriation occurs, the poor patient is stuck with half a body, pretty much helpless.

[Conservativesux]

6. Who said anything about Medicare here?

2004 convalecent home costs: $3000 to $5000 dollars a month minimum depending on the patients'location.

BTW, 1500 dollars for a couple of shots of medicine is peanuts to the medical for-profit organisations. Long-term patients are what they need and want.

[October]

15. $5K - 7K here in the NE

My mother had a stroke, and as she is half paralyzed, is now in a nursing home.

She is 62. Went into cardiac arrest after elective surgery (Surgery that was to "give her a better quality of life.")

My mother was a HEAVY smoker, and was overweight; she shouldn't have been a candidate for surgery in her condition. Past issues with aorta valve replacement...birth defect...

Anyway...it's expensive.

[Conservativesux]

16. I am very sorry to hear that October. My Grandma went the same way.

[Lauri16]

2. I've read about cases

where the ER mistakenly administered t-PA to patients that had a hemoragic(sp) stroke (an actual bursting of a blood vessel). t-PA is only for Ischemic stroke patients(clots). With a 3 hour window, they need to scan to make sure that nothing has actually burst instead of assuming.

[Conservativesux]

4. The article says that patients are often just to the sent to the nearest

...hospital, not necessarily one with the necessary equipment and expertise to give TPA.

[madrchsod]

8. that is what my mom died of

a massive hemoragic stroke...it was cruel.

[madrchsod]

7. my mom died of a stroke

the doctors were going to fly her to another hospital but her stroke was so bad we decided to let her go. any dratic procedure would have been cruel. if this treatment were offered to those who had a chance well maybe it would be worth the risk and money...sometimes it`s someone`s time to go..

[Lauri16]

14. madrchsod.......

I'm sorry about your Mom. I'm interested in knowing why they wanted to fly her to another hospital, though. With a massive hemoragic stroke, there's really nothing that can be done except hook the person up to a bunch of machines and keep them going artificially & racking up the bill..........maybe I just answered my own question.

[reprobate]

9. I'd like to see the same study compared to canadian results.

That would compensate for the for-profit motivations of the american system.

[Conservativesux]

10. I agree. I would be very interested in such a study.

[LeftCoast]

11. Listen, if you think doctors and nurses

really look at a sick patient and think to themselves..."hmm, I think I'll just let this one get sicker so my hospital can get more money..." then you have no understanding of the medical profession and you obviously don't know a single doctor or nurse.

[yardwork]

12. I agree with this - most medical professionals are caring people!

The systemic problems in the U.S. health system are not primarily the fault of doctors, and certainly not the fault of nurses or primary care providers.

Lay the fault at the door of the wealthy, power-hungry corporations and government interests (what's the difference, these days?) - not on the dedicated, hard-working people struggling to actually help people.

[Conservativesux]

13. But not greedy hospitals, drug companies and insurers.....

And please read the news, folks.

Hospitals have repeatedly been found to be overcharging for common medical procedures, medications, bandages, ect. or do you think a pill that costs .05 cents in a bottle, should cost a patient 500% that when they are sick in the hospital?

Medical practice is a "for-profit" INDUSTRY in the USA.