Most Kentucky hospitals did average or better in new patient satisfaction ratings; seven got top rating and six got bottom rating

Most of the Kentucky hospitals that were rated on a newly released five-star scale for patient satisfaction got three and four stars. Seven of them got a five-star rating and six got a two-star rating, the lowest rating given to any of the Kentucky hospitals that were evaluated.

The star ratings can be found on Medicare's Hospital Compare website and are based on a patient satisfaction survey given to randomly selected patients, not just those on Medicare, at nearly 3,500 Medicare-certified acute care hospitals across the country. The ratings are based on patient admissions between July 2013 and June 2014. Hospitals were not included if they did not have enough surveys completed during that period.

The survey, also known as Hospital Consumer Assessment of Healthcare Providers and Systems Survey, includes questions about patient satisfaction related to how their doctors, nurses and hospital staff communicated with them, how well their pain was addressed during their hospital stay, how well they were prepared to go home, cleanliness of the hospital and if they would recommend the hospital to others.

Kaiser Health News analyzed the data from the Centers for Medicare & Medicaid Services and found that 76 Kentucky hospitals were included in the patient satisfaction star ratings and 17 Kentucky hospitals were not. Kaiser found that the average for all of the rated hospitals in Kentucky was 3.4 stars, one-third, or 25, got four stars; half, or 38, got three.

HealthWatch USA, a non-profit organization that promotes health care transparency and patient advocacy based in Somerset, further analyzed the data and named the hospitals in each state by its star rating.

The seven with five-star ratings are: Clinton County Hospital, Marshall County Hospital, Westlake Regional Hospital, Saint Joseph Martin, Rockcastle County Hospital, Pikeville Medical Center and Russell County Hospital.

The six with two-star ratings are: Georgetown Community Hospital, Harlan ARH Hospital, Hazard ARH Regional Medical Center, Spring View Hospital in Lebanon, University of Louisville Hospital and Lake Cumberland Regional Hospital in Somerset.

The Centers for Medicare and Medicaid Services reminds consumers that these patient satisfaction star ratings are just one tool to help decide which hospital to use, and encourages them to use multiple factors to make this decision, including clinical outcomes, their health-care providers opinion and other publicly reported data.

Study finds nutritious food costs more in poor, rural areas, suggests that SNAP (food stamp) policies be changed

A study has found that nutritious foods are more expensive in impoverished rural counties than in urban counties, a phenomenon that doesn't help public health officials who teach healthy eating as a proven, effective strategy to prevent chronic diseases to rural Kentuckians.

"The results of this study find that individuals living in rural areas, particularly food desserts, may be at increased risk of negative health effects as a result of more limited access to higher quality foods compared to those living in urban areas," says the report of the University of Kentucky study, "Food Cost Disparities in Rural Communities," published in Health Promotion Practice.

Researchers analyzed the per-serving cost of 92 foods four times over a 10-month period in the primary grocery stores in four Kentucky counties, two rural and two urban. One rural county was considered a food desert, meaning that fresh produce isn't relatively available. The commonly purchased foods in the study were assigned to one of four categories based on their nutritional value.

Not surprisingly, the cheapest foods were those with the least nutritional value, such as canned fruit in heavy syrup, cereals with high-fructose corn syrup, and processed meats.

Foods that are a bit more nutritional, but mainly processed convenience foods, were more expensive in rural counties than urban counties.

Foods that were considered nutritious, but not the most nutritious, such as white rice, oats, whole-grain bran cereals and frozen fish, cost the most in the rural county with the highest poverty rate.

The cost of the most nutritional items varied by county, with the "most striking finding" being that "the rural food desert had significantly higher per-serving costs among the most nutritious food items, compared to the other three counties," 6 to 8 cents higher per item, the report said.

Within each county, the study did not find much difference in food cost among the foods in each of the four nutrition categories.

However, it did find that highly processed convenience foods in urban counties were more expensive than more nutritional foods, and suggested that those living in urban areas could afford more plant-based foods and fewer processed foods as an "effective strategy to improve overall dietary quality without increasing food budgets."

The study draws attention to the SNAP or food-stamp program, which makes no allowances for food cost differences between regions or counties, and suggests that its model be changed to be more like the Women, Infants and Children program, which uses a portion-based system: Participants buy a set number of ounces or servings of dairy products, whole grains, and fresh produce each month, irrespective of price. This approach "has the potential to adequately meet all participants' nutritional needs, irrespective of differences in food prices," wrote the researchers, Frances Hardin-Fanning and Mary Kay Rayens of the UK College of Nursing.

Most women are unaware of female-specific stroke symptoms and risks, according to a national survey by Ohio State

Most women are unaware of the symptoms and risks of stroke for females, according to a national survey by the Ohio State University's Wexner Medical Center. The survey found that just 11 percent of the 1,000 respondents knew that pregnancy, lupus, migraine headaches and oral contraception or hormone replacement therapy are female-specific stroke risks.

Also, only 10 percent of those surveyed knew that hiccups and atypical chest pain with or followed by typical stroke symptoms are early warning signs. According to the National Stroke Association, stroke is the third leading cause of death for women, and Diana Greene-Chandos, a neurologist and director of the neuroscience critical care at Ohio State's Wexner Medical Center, said, "We have a ways to go when it comes to educating women about stroke and their unique risk factors."

Other symptoms unique to women include dizziness that is not class vertigo, headaches, atypical chest pain and/or numbness of the body, especially if one side is more numb than the other. Early recognition and treatment are key for strokes.

"Women do not think they are going to have a stroke," said Greene-Chandos. "They think of it as a man's disease." The reality is that 60 percent of stroke deaths occur in females and 40 percent for males. Every year, 137,000 Americans die from a stroke. Smoking, failing to exercise and having high blood pressure are risk factors for both men and women. To take an assessment created by Ohio State's stroke experts to determine risk of stroke, click here.

Teen use of electronic cigarettes has tripled in one year

By Melissa Patrick
Kentucky Health News

The number of middle- and high-school students using electronic cigarettes tripled from 2013 to 2014, surpassing the current use of all teen use of tobacco products, including conventional cigarettes, according to the federal Centers for Disease Control and Prevention.

Data from CDC/CDC National Youth
Tobacco Survey; Image: NPR

The findings came from CDC's 2014 National Youth Tobacco Survey,which found that e-cigarette use by high-school students increased to 13.4 percent in 2014 from 4.5 percent in 2013, and to 3.9 percent in 2014 from 1.1 percent in 2013 for middle-school students. That amounts to 2 million high school students and 450,000 middle school students smoking e-cigarettes.

The report also found that the use of traditional cigarettes remained the same for middle-school students at 7.7 percent, but fell among high-schoolers to 9.2 percent in 2014 from 12.7 percent in 2013, the "lowest level in years," CDC said in a press release.

“We want parents to know that nicotine is dangerous for kids at any age, whether it’s an e-cigarette, hookah, cigarette or cigar,” CDC Director Tom Frieden said. “Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.”

There is great debate about how safe e-cigarettes are. Most public-health officials have called for them to be controlled by government regulations, including advertising regulations, and say more controlled studies need to be done to determine their safety.

And while many proponents of e-cigarettes say the devices may be helpful in helping some smokers give up traditional cigarettes and are safer than traditional cigarettes, a recent study published in the American Journal of Public Health says that using electronic cigarettes doesn't help smokers quit, and Brady Dennis of The Washington Post reports that another study, published in the journal Tobacco Control, found that the chemicals used to flavor e-cigarettes could prove unsafe when inhaled over time.

The U.S. Food and Drug Administration has yet to issue new regulations for e-cigarettes, despite its announced plans to do so last April. Meanwhile, Kentucky enacted a law last year banning the sale of "alternative nicotine products" such as e-cigarettes to minors, and local Kentucky smoking bans have slowly been adding e-cigs to their local ordinances. Several Kentucky schools have also added language to their school policies to include e-cigarettes in their smoking bans, with one school official in Webster County recently saying e-cigarettes are "high on every school system's radar right now."

But not everyone sees this increase in teen use of e-cigarette use as a cause for alarm.

“The CDC should really be jumping for joy at the fact that smoking rates are declining. This is a huge success,” Michael Siegel, a professor and tobacco-control specialist at Boston University’s School of Public Health, told Dennis. “Instead, they are using this as another opportunity to demonize e-cigarettes.”

Siegel said that while minors shouldn't have access to any tobacco products, the CDC numbers also suggest that e-cigarettes are not serving as a gateway to traditional cigarettes and might be diverting them away from them, Dennis reports.

Gregory Conley of the American Vaping Association told NPR that the data, which show a decrease in tobacco smoking by teens as they have increased experimentation with vaping "should be part of the discussion."

Kynect has an app for smartphones

Kentucky's state health benefits exchange, Kynect, is offering a free mobile app that will provide "on-the-go" access to the health-insurance marketplace.

The  smartphone app will allow you to log in to your account, browse plans, report changes in your circumstances, take photos of required verification documents and upload those photos directly to your account.

It can also help determine if you qualify for low-cost or free health coverage, get information about your coverage options, find out enrollment dates and learn how certain life events can qualify you to enroll now.

It allows you to log in to your Kentucky Online Gateway Account, look at the status of your health care plan or application, get more information about your current health care plan, access alerts, notifications or messages related to your account and view and update contact information.

And if you have further questions, it can connect you to an insurance agent or nearby "Kynector."

The app is available for download in the iTunes Store for Apple devices or in the Google Play Store for Android users.