A new American Fitness Index report, published by the American College of Sports Medicine, has revealed survey results from America’s largest metropolitan areas.
Ranking 50 communities by fitness levels, obesity rate and 30 other factors came up with a few surprises.
1. Washington, D.C.
• Overall Score: 73.5
• Obesity Rate: 22.6%
• Exercise Rate: 80.1 %
Given the sedentary rate of bureaucrats, you wouldn’t think of this as the #1 city, but this East Coast metropolis likes its veggies and farmers markets, has a low percentage of population with diabetes or heart rate, and has a high ratio of parks to residents.
2. Boston, Massachusetts
• Overall Score: 72.6
• Obesity Rate: 19.9%
• Exercise Rate: 78.6%
One of the few states that mandates health insurance, residents enjoy a high rate of health care providers, parks and recreation offerings, and keep smoking to a minimum.
3. Minneapolis, Minnesota
• Overall Score: 71.7
• Obesity Rate: 29.5%
• Exercise Rate: 84.3%
The higher obesity rate is offset by a physically active community, where people cycle to work and love to play golf and tennis.
4. Seattle, Washington
• Overall Score: 70.5
• Obesity Rate: 22.8%
• Exercise Rate: 81.9%
This is an area with abundant parkland and outdoor activities, from boating on one of the lakes or bays, to cycling and jogging.
5. Portland, Oregon
• Overall Score: 70.4
• Obesity Rate: 23.9%
• Exercise Rate: 82.3%
Public transit is big in this Northwest area and is used in conjunction with walking and cycling. There is also a lower percentage of smokers and people affected with diabetes.
6. Denver, Colorado
• Overall Score: 69.9
• Obesity Rate: 19.3 %
• Exercise Rate: 83%
A physically active town with more than its share of swimming pools, golf courses, tennis courts and baseball diamonds.
7. Sacramento, California
• Overall Score: 65.8
• Obesity Rate: 21.4%
• Exercise Rate: 82.3%
Sitting in the heart of California’s farmland, farmers markets and farm stands are plentiful meaning that residents get their fill of fruits and vegetables. Add to that the high number who cycle or walk to work and the abundance of parks, playgrounds and recreational amenities.
8. San Francisco, California
• Overall Score: 64.7
• Obesity Rate: 18.4%
• Exercise Rate: 81.5%
A slightly lower obesity rate than its northern cousin, but residents don’t quite get as much exercise. The factors affecting these scores is pretty identical to those of Sacramento.
9. Hartford Connecticut
• Overall Score: 64.4
• Obesity Rate: 21.1%
• Exercise Rate: 77.2%
Higher incomes and lower poverty rate contribute to these scores, along with recreational amenities and higher numbers of primary health care providers.
10. Austin, Texas
• Overall Score: 63.9
• Obesity Rate: 22.5%
• Exercise Rate: 78.4%
The lone Southern community to be ranked in the top 10, employment and diet have a lot to do with its success in this ranking, as well as keeping asthma, diabetes and cardiovascular disease lower.
Friday, June 18, 2010
Thursday, June 10, 2010
10 dirtiest hospital secrets [chapter5]
9. "Stay away from hospitals in July like the plague."
If possible, stay out of hospital during the summer, especially July. That is the month when medical students are interns, interns become residents and fellows and medical residents in networking. In other words, a good part of the staff in a teaching hospital because it is new to the job.
Summer hospital horror stories are not just medical science: The adjusted mortality rate rises to 4% in July and August for the average major teaching hospital, according to the National Bureau of Economic Research. That means that the deaths of eight to 14 more are produced in major teaching hospitals than normal without the turnover.
Another programming advice: Try to book surgeries first thing in the morning, preferably early in the week, when doctors are at their best and before schedules the backup.
10. "Sometimes we do not know how to keep his mouth zipped."
Contrary to belief, the exchange of patient information with a third party is often perfectly legal. In some cases, the law allows your medical records to be disclosed without asking or even notifying you. For example, hospitals will deliver information about your treatment to other doctors, and easily share the details with insurance companies to make payments.
That means that about millions of entities that are not heavily involved in the system of health care have access to this information. These matches can even transfer the data to its trading partners, says Deborah Peel, founder of the Foundation of Patient Privacy Rights in Austin, Texas.
If possible, stay out of hospital during the summer, especially July. That is the month when medical students are interns, interns become residents and fellows and medical residents in networking. In other words, a good part of the staff in a teaching hospital because it is new to the job.
Summer hospital horror stories are not just medical science: The adjusted mortality rate rises to 4% in July and August for the average major teaching hospital, according to the National Bureau of Economic Research. That means that the deaths of eight to 14 more are produced in major teaching hospitals than normal without the turnover.
Another programming advice: Try to book surgeries first thing in the morning, preferably early in the week, when doctors are at their best and before schedules the backup.
10. "Sometimes we do not know how to keep his mouth zipped."
Contrary to belief, the exchange of patient information with a third party is often perfectly legal. In some cases, the law allows your medical records to be disclosed without asking or even notifying you. For example, hospitals will deliver information about your treatment to other doctors, and easily share the details with insurance companies to make payments.
That means that about millions of entities that are not heavily involved in the system of health care have access to this information. These matches can even transfer the data to its trading partners, says Deborah Peel, founder of the Foundation of Patient Privacy Rights in Austin, Texas.
Tuesday, June 8, 2010
10 dirtiest hospital secrets [chapter4]
7. "All hospitals are not created equal."
How to tell a good hospital from a bad one? For one thing, nurses. When it comes to their own families, medical workers favor institutions that attract nurses. But they are harder to find as the country's nursing shortage intensifies, for 2020, a deficit of about 1 million nurses. staffing under the nurse directly affected patient outcomes resulting in more problems such as urinary tract infections, shock and gastrointestinal bleeding, according to a 2001 study by Harvard and Vanderbilt University professors.
Another thing to consider: The local hospital could have been great to welcome his son into the world, but that does not mean it is the best place to undergo open heart surgery. Find the installation with the longest record of the track, the better survival rate and higher volume in the proceeding; dont want to be the replacement of hip team in third place, says Samantha Collier, HealthGrades chief medical officer, the hospital fees.
A website of the American Nurses Association lists "magnet" hospitals - those most attractive to nurses - and a call to the supervising nurse of a hospital must provide the nurse-patient relationship.
A good tool to help consumers evaluate hospitals is a website operated by the Department of Health and Human Services hospitals compared with national averages in certain areas. The site includes information about the ability of hospitals caring for patients with certain medical conditions, and the results of patient surveys asking them about their stay, said Anne F. Weiss, senior program director of the Robert Wood Johnson Foundation, a health care nonprofit.
8. "Most ERs are in need of some urgent care themselves."
A 2007 study from the Institute of Medicine found that emergency departments are overburdened hospitals, funds and ill-prepared to handle disasters as the number of people using ERs for primary care continues to rise. An ambulance was turned away from an ER once every minute due to overcrowding, according to the study, the situation is aggravated by the scarcity of many backup services on call for cardiologists, orthopedists and neurosurgeons.
Almost three quarters of ER directors reported inadequate coverage by specialists on call versus 67% in 2004, according to a 2006 survey conducted by the American College of Emergency Physicians.
If you can, avoid the RE 3 pm-1 am - The most active of change. For a short wait, early morning - anywhere 4-9 am - is your best bet. If you are having severe symptoms, such as the worst headache of your life or chest pains, a triage nurse is trained to recognize whether your symptoms are a medical emergency. I only know that the emergency department staff are stressful during busy times, but give "honest descriptions of their symptoms and really work with the staff is the best way to advocate for you and your family as a patient," says Darria E. Long, a doctor in the Yale department of emergency medicine.
How to tell a good hospital from a bad one? For one thing, nurses. When it comes to their own families, medical workers favor institutions that attract nurses. But they are harder to find as the country's nursing shortage intensifies, for 2020, a deficit of about 1 million nurses. staffing under the nurse directly affected patient outcomes resulting in more problems such as urinary tract infections, shock and gastrointestinal bleeding, according to a 2001 study by Harvard and Vanderbilt University professors.
Another thing to consider: The local hospital could have been great to welcome his son into the world, but that does not mean it is the best place to undergo open heart surgery. Find the installation with the longest record of the track, the better survival rate and higher volume in the proceeding; dont want to be the replacement of hip team in third place, says Samantha Collier, HealthGrades chief medical officer, the hospital fees.
A website of the American Nurses Association lists "magnet" hospitals - those most attractive to nurses - and a call to the supervising nurse of a hospital must provide the nurse-patient relationship.
A good tool to help consumers evaluate hospitals is a website operated by the Department of Health and Human Services hospitals compared with national averages in certain areas. The site includes information about the ability of hospitals caring for patients with certain medical conditions, and the results of patient surveys asking them about their stay, said Anne F. Weiss, senior program director of the Robert Wood Johnson Foundation, a health care nonprofit.
8. "Most ERs are in need of some urgent care themselves."
A 2007 study from the Institute of Medicine found that emergency departments are overburdened hospitals, funds and ill-prepared to handle disasters as the number of people using ERs for primary care continues to rise. An ambulance was turned away from an ER once every minute due to overcrowding, according to the study, the situation is aggravated by the scarcity of many backup services on call for cardiologists, orthopedists and neurosurgeons.
Almost three quarters of ER directors reported inadequate coverage by specialists on call versus 67% in 2004, according to a 2006 survey conducted by the American College of Emergency Physicians.
If you can, avoid the RE 3 pm-1 am - The most active of change. For a short wait, early morning - anywhere 4-9 am - is your best bet. If you are having severe symptoms, such as the worst headache of your life or chest pains, a triage nurse is trained to recognize whether your symptoms are a medical emergency. I only know that the emergency department staff are stressful during busy times, but give "honest descriptions of their symptoms and really work with the staff is the best way to advocate for you and your family as a patient," says Darria E. Long, a doctor in the Yale department of emergency medicine.
Saturday, June 5, 2010
10 dirtiest hospital secrets [chapter3]
5. "Yes, we take your insurance, but we are not sure about the anesthesiologist."
The last thing on your mind before surgery is to ensure that all doctors involved in the network. But because the answer is often no for anesthesiologists, pathologists and radiologists, which is a patient to do?
Los Angeles entertainment attorney and patient advocate Michael A. Weiss repeatedly turned away out of network medical management of pain in a hospital visit.
If you are alert enough, ask someone in your network. If you're seeing a doctor or go to any medical facility, call your insurance company to obtain a current list of network doctors, hospitals and laboratories. Also, if the appointment was referred by his primary care physician, the application programming staff to find specialists, hospitals and laboratories in the network. Then check with your insurance company, says Mary Jane Stull, President and CEO of the Patient Advocate, a company in South Bend, Indiana, which helps people with medical insurance claims.
Medical providers may withdraw from a network between the pre and postoperative appointment the actual date. And if you know your procedure is outside the network, call the medical providers: physicians, surgeon, anesthesiologist and hospital. It might be worth trying to negotiate a price and payment plan with the billing department, Stull said.
6. "Sometimes we bill you twice."
Find the code of medical bills, and you may find some surprises: charges for services never received or routine items such as gowns and gloves, which will not be charged separately. material errors often the reason for errors. A number added to a billing code can result in a charge for placing a catheter into an artery in comparison with a vein - which can reach a difference of thousands of dollars.
So how to find out if your bill is incorrect codes or duplicate charges? Start by asking for an itemized bill with a breakdown of all charges clearly defined, says Dr. Geni Bennetts, director of Health Promotion Resolve billing Napa, California Some errors revealing: charge for three days he was kept in hospital for night, a circumcision to newborn girl or drugs he never received. Ask the hospital billing office for a key to decrypt the charges, or hire an expert to detect problems and deal with the insurance company and doctors (you can find one in Defenders Medical Billing of America) .
His experience will usually cost between $ 65 and $ 85 per hour, a percentage of the savings, or some combination of both. You want to be your own detective billing, talk to the senior manager you can find on the funding of hospital or in the accounts to begin to unravel any code wrong.
The last thing on your mind before surgery is to ensure that all doctors involved in the network. But because the answer is often no for anesthesiologists, pathologists and radiologists, which is a patient to do?
Los Angeles entertainment attorney and patient advocate Michael A. Weiss repeatedly turned away out of network medical management of pain in a hospital visit.
If you are alert enough, ask someone in your network. If you're seeing a doctor or go to any medical facility, call your insurance company to obtain a current list of network doctors, hospitals and laboratories. Also, if the appointment was referred by his primary care physician, the application programming staff to find specialists, hospitals and laboratories in the network. Then check with your insurance company, says Mary Jane Stull, President and CEO of the Patient Advocate, a company in South Bend, Indiana, which helps people with medical insurance claims.
Medical providers may withdraw from a network between the pre and postoperative appointment the actual date. And if you know your procedure is outside the network, call the medical providers: physicians, surgeon, anesthesiologist and hospital. It might be worth trying to negotiate a price and payment plan with the billing department, Stull said.
6. "Sometimes we bill you twice."
Find the code of medical bills, and you may find some surprises: charges for services never received or routine items such as gowns and gloves, which will not be charged separately. material errors often the reason for errors. A number added to a billing code can result in a charge for placing a catheter into an artery in comparison with a vein - which can reach a difference of thousands of dollars.
So how to find out if your bill is incorrect codes or duplicate charges? Start by asking for an itemized bill with a breakdown of all charges clearly defined, says Dr. Geni Bennetts, director of Health Promotion Resolve billing Napa, California Some errors revealing: charge for three days he was kept in hospital for night, a circumcision to newborn girl or drugs he never received. Ask the hospital billing office for a key to decrypt the charges, or hire an expert to detect problems and deal with the insurance company and doctors (you can find one in Defenders Medical Billing of America) .
His experience will usually cost between $ 65 and $ 85 per hour, a percentage of the savings, or some combination of both. You want to be your own detective billing, talk to the senior manager you can find on the funding of hospital or in the accounts to begin to unravel any code wrong.
Thursday, June 3, 2010
10 dirtiest hospital secrets [chapter2]
3. "Good luck finding the person in charge."
Helen Haskell repeatedly told nurses something did not seem right with his son Lewis, who was recovering from surgery to repair a defect in the wall of his chest. For nearly two days following asking a veteran - or "participants" - when assessing first-year medical resident seemed off. But Haskell could not convince the right people that her son was deteriorating.
"It was like an alternate reality," he says. "I had no idea where to go." Thirty hours after her first child complained of severe pain, the South Carolina teen died of a perforated ulcer.
In a sea of blue gowns, calling attention to the right person can be difficult. Who's in Charge? Nurses do not report to doctors, but rather to a nursing supervisor. And your personal doctor has little say over radiology or the labs running your tests, which are administered by the hospital. Some facilities employ "hospitalists" - doctors who act as a key person to carry out the flow of information. Most hospitals now have rapid response teams - trained personnel that can run alongside the bed to assess a patient's decline. Haskell urges patients to know the hierarchy of the hospital, read the name tags, get the doctor's phone number and know how to get quick response team. If all else fails, demand a nursing supervisor - probably the most senior person that can be accessed quickly.
4. "Everything is negotiable, including the hospital bill.
When it comes to getting care, hospitals have to work hard for them. Medical bills are one of the leading causes of bankruptcy in the U.S., and when collectors are put on the case, they take up to 25% of what is claimed, according to Dr. Mark Friedman, founder of billing for consulting services Premium HealthCare. This leaves room for some negotiation.
If you are among the uninsured - which can pay up to three times more for procedures - not hurt to ask for a deduction. Some hospitals offer a 35% to 40% discount for uninsured patients, says Candice Butcher, CEO of Medical Billing Lawyers of America. Hospitals frequently work with patients that offer payment plans or discounts. But to succeed, you have to call the right door: Look for the office of patient accounts or the financial aid office.
If you do not have insurance and are scheduled for a colonoscopy in a week, Butcher suggests doing some research to find out how much of this procedure is typically run in your area. Health Blue Book site allows users to access health care prices by zip code. You can use that as a negotiating tool. But remember, "if the hospital agrees to your price, you have to get it in writing and signed it receives," says Butcher.
Helen Haskell repeatedly told nurses something did not seem right with his son Lewis, who was recovering from surgery to repair a defect in the wall of his chest. For nearly two days following asking a veteran - or "participants" - when assessing first-year medical resident seemed off. But Haskell could not convince the right people that her son was deteriorating.
"It was like an alternate reality," he says. "I had no idea where to go." Thirty hours after her first child complained of severe pain, the South Carolina teen died of a perforated ulcer.
In a sea of blue gowns, calling attention to the right person can be difficult. Who's in Charge? Nurses do not report to doctors, but rather to a nursing supervisor. And your personal doctor has little say over radiology or the labs running your tests, which are administered by the hospital. Some facilities employ "hospitalists" - doctors who act as a key person to carry out the flow of information. Most hospitals now have rapid response teams - trained personnel that can run alongside the bed to assess a patient's decline. Haskell urges patients to know the hierarchy of the hospital, read the name tags, get the doctor's phone number and know how to get quick response team. If all else fails, demand a nursing supervisor - probably the most senior person that can be accessed quickly.
4. "Everything is negotiable, including the hospital bill.
When it comes to getting care, hospitals have to work hard for them. Medical bills are one of the leading causes of bankruptcy in the U.S., and when collectors are put on the case, they take up to 25% of what is claimed, according to Dr. Mark Friedman, founder of billing for consulting services Premium HealthCare. This leaves room for some negotiation.
If you are among the uninsured - which can pay up to three times more for procedures - not hurt to ask for a deduction. Some hospitals offer a 35% to 40% discount for uninsured patients, says Candice Butcher, CEO of Medical Billing Lawyers of America. Hospitals frequently work with patients that offer payment plans or discounts. But to succeed, you have to call the right door: Look for the office of patient accounts or the financial aid office.
If you do not have insurance and are scheduled for a colonoscopy in a week, Butcher suggests doing some research to find out how much of this procedure is typically run in your area. Health Blue Book site allows users to access health care prices by zip code. You can use that as a negotiating tool. But remember, "if the hospital agrees to your price, you have to get it in writing and signed it receives," says Butcher.
Tuesday, June 1, 2010
10 dirtiest hospital secrets
1. "Oops, wrong kidney."
In recent years, errors in treatment have become a serious problem for hospitals, ranging from operations in parts of the body to the wrong medication mix-ups.
At least 1.5 million patients are harmed every year by medication errors, according to the Institute of Medicine of the National Academy of Sciences. One reason these mistakes persist: Only 15% of hospitals are fully computerized, with a central database to track allergies and diagnoses, Robert Wachter said, the chief of medical service at the University of California at San Francisco Medical Center.
But signs of change are emerging. More than 3,000 U.S. hospitals, or 75% of beds in the country, signed a contract to a campaign by the Institute for Healthcare Improvement to implement preventive measures such as controls on multiple drugs. In the first 18 months of the campaign, these hospitals have prevented an estimated 122 300 deaths.
Although the system is improving, still has a long way to go. Patients should always have a friend, relative or patient advocate from the hospital staff at his side to take notes and make sure that the right medicines are being distributed.
2. "After leaving the hospital does not mean you are out of danger."
A recently published study by Resources for the Future, a nonprofit group that undertakes independent research on public health issues, said that infections sepsis and hospital-acquired pneumonia can kill 48,000 people each year. What's more, the study shows, these infections cost $ 8,100,000,000 to treat and result in 2.3 million total days of hospitalization.
These revelations, along with the recent increase in antibiotic-resistant bugs and the mounting cost of health care, have mobilized the medical community to implement procedures to reduce infections. These include using clippers rather than a razor to shave surgical sites and administering antibiotics before surgery, but shortly after stopping them to avoid drug resistance.
For all the advances of modern medicine, the best way to minimize the risk of infection is low-tech: Make sure someone touches you wash your hands. Tubes and catheters are also a source of errors, and patients should ask daily if necessary.
In recent years, errors in treatment have become a serious problem for hospitals, ranging from operations in parts of the body to the wrong medication mix-ups.
At least 1.5 million patients are harmed every year by medication errors, according to the Institute of Medicine of the National Academy of Sciences. One reason these mistakes persist: Only 15% of hospitals are fully computerized, with a central database to track allergies and diagnoses, Robert Wachter said, the chief of medical service at the University of California at San Francisco Medical Center.
But signs of change are emerging. More than 3,000 U.S. hospitals, or 75% of beds in the country, signed a contract to a campaign by the Institute for Healthcare Improvement to implement preventive measures such as controls on multiple drugs. In the first 18 months of the campaign, these hospitals have prevented an estimated 122 300 deaths.
Although the system is improving, still has a long way to go. Patients should always have a friend, relative or patient advocate from the hospital staff at his side to take notes and make sure that the right medicines are being distributed.
2. "After leaving the hospital does not mean you are out of danger."
A recently published study by Resources for the Future, a nonprofit group that undertakes independent research on public health issues, said that infections sepsis and hospital-acquired pneumonia can kill 48,000 people each year. What's more, the study shows, these infections cost $ 8,100,000,000 to treat and result in 2.3 million total days of hospitalization.
These revelations, along with the recent increase in antibiotic-resistant bugs and the mounting cost of health care, have mobilized the medical community to implement procedures to reduce infections. These include using clippers rather than a razor to shave surgical sites and administering antibiotics before surgery, but shortly after stopping them to avoid drug resistance.
For all the advances of modern medicine, the best way to minimize the risk of infection is low-tech: Make sure someone touches you wash your hands. Tubes and catheters are also a source of errors, and patients should ask daily if necessary.
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