Sunday, August 06, 2006

Seriously, CT sucks

I live in the wealthiest state in the country. I live in Connecticut. I hate Connecticut. I plan to leave as soon as I am able.

I just read an AP story which gives me more reason to dislike Connecticut. According to the story, a study by the State of Connecticut's Office of Health Care Access shows that residents of CT visit the ER at a rate that is above the national average.

(from the OHCA report)
In 2003, the national ED utilization rate was just under 400 visits per 1,000 population, as compared to 420 per 1,000 in Connecticut.

Worse, the 2003 CT ER rate is up not only above the national average for 2003 but also above the CT rates for 2001 and 2002. From 03 to 04, CT showed an ER "utilization" rate increase of 2% (national data for 2004 isn't available yet).

So what the hell is up with Connecticut? It seems we do not do a good job taking care of our people. This does not need to be the case. Connecticut has the highest per capita income in the US. The region has the second, third, fourth, fifth, and sixth highest per capita income. We are a rich state surrounded by other rich states. It would seem we have the financial potential to take care of our citizens (maybe if we were able to bring ourselves to part with the notions of having only 2 state personal income tax brackets and one of the region's lowest corporate tax rates) . Is it that we have a state government that has spent far too many years assuaging the deep pocketted minority who faithfully pay for their re-elections, home improvements, and insulated blitheringly ignorant policies? Or maybe we just have a lot of lazy average citizens who have nothing better to do on any given night but go take up space in the ER? I suspect it is not the latter, as it seems the increase in ER usage reflects an increase in ER need (again from the same OCHA report):

Inpatient admissions through the ED increased from 44% in FY 2001 to 50% in FY 2005.
And
...In FY 2005, admissions through the ED were frequently more serious than routine admissions. While routine admissions were frequently birthrelated, ED admissions were more likely to involve respiratory or coronary diagnoses.

Am I being too mean to little old Connecticut? Isn't this just a reflection of trends in the national economy? According the chairman of emergency medicine at Connecticut's Norwalk Hospital Michael Carius (AP - Boston Globe) reasons for the trend in increased use of the ER include "a larger population that is also aging", "a growing number of uninsured and underinsured patients who rely on emergency rooms as their sole source of health care", and "a shortage of primary care physicians and specialty doctors".

It isn't clear from the context of these items in the AP story whether Carius meant all three of the listed factors were part of the national trend or whether some were specific to CT (like the shortage of PCPs and specialists). Even if for the sake of argument we assume that Carius meant them as general reasons for a national trend in increased ER use, if those reasons are valid, then it follows that CT has must have all those same general factors going on as well. This, in addition to the the information from the OHCA report regarding increased admits through the ER (compared to non ER admits), suggests that the richest state in the nation is outpacing the national average by simply letting our sick people rot.

And so I say, take Connecticut. Please.

2 comments:

Malnurtured Snay said...

What is there in Connecticut that is sending so many people to the ER? I thought lousy drivers were Boston's thing, and drive-by shootings New York's.

PFG said...

Ok, let's see what we got.
Actually, the horrible drivers are in Rhode Island. I'm not saying that b/c I grew up 5 miles out of downtown boston. I'm saying it because although the boston drivers are scary, the RI ones are (gulp) SCARIER.

This is not a comprehensive or exhaustive list, just a couple of ideas about what's taking down or out the good people of this FINE state.

Aside from the national trends like increasing rates of diabetes, CT does have it's own health risk issues (I mean aside from the risk to everyone who lives here which is presented by having a health care system that cannot or will not serve the majority of people until they become acutely and seriously ill).

CT is an extremely polluted state - from the NY Times 8/20/00: A screening of Hartford children for asthma shows that 41 percent have the illness, which city officials and environmental activists believe is the highest rate in the country. Among the city's Latino youngsters, the rate is 48 percent.

Pulmonary problems (pneumonia) were high up on the list of reasons for admit through the ER in (I think) 04.

Then there's the Lyme disease and two other nasty infections that go with it. Advanced Lyme can have serious effects on the nervous system and/or heart, both of which manifestations could quite likely and legitimately send someone to the ER for diagnosis or treatment.

And lastly, I wanted to point out that CT's cities have non-negligible problems with violence, at least not in comparison with the rest of the country.
In Connecticut's major cities, violent crime was up slightly in Bridgeport and Stamford and down slightly in Waterbury and Hartford, which has recently dealt with a spate of random shootings. Statistics for New Haven were not included in the report. Murders increased in all four cities, while robberies and rapes were up in Stamford and Bridgeport and down in Hartford and Waterbury. In Hartford, for example, murders jumped more than 50 percent, from 16 to 25. (AP - Globe, 6/12/06)


According to that story, the FBI violent crime statistics for 05 showed national murder rate was up 4.8% from 04 to 05. In Hartford, the increase was 50%. And NYC along with Detroit and L.A. showed a decrease in murder rates.

I wonder why people think (it is the thought that underlies the joke as a presupposition...w/o at least the belief that there is wide spread belief that the circumstances of the supposition hold, then there is no joke) that this sort of shit is restricted to NY(C)? Whenever the economy is bad enough long enough, it gets ugly all over.