Despite the federal law that bars emergency departments from refusing to treat patients with acute medical conditions, lax enforcement and monitoring allow patient dumping to continue, argue the authors of a case study in the August Health Affairs.

In a separate article in the journal, a group of emergency care experts argues that many hospitals have been slow to take action to address patient boarding. The practice occurs when an emergency physician has admitted a patient to the hospital but the patient remains in the ED because there is no inpatient bed available.

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Nearly 800 physician practices around the country are participating in a program that gives soon-to-expire pharmaceutical sample medications to low-income, uninsured patients at safety-net clinics.

The Nashville, Tenn.-based service, Dispensary of Hope, has brought in more than $9 million worth of samples in the last year from practices in 30 states. In turn, the drugs have been dispensed to 80 community health centers and charitable pharmacies in 15 states.

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A group of 37 physicians in July petitioned the Food and Drug Administration to no longer approve the use of opioid analgesics in patients with moderate noncancer pain. The FDA has until the end of the year to respond to the petition, which is the latest entry in the fierce debate about the proper boundaries of opioid prescribing for patients with chronic pain.

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Innovative technology that can track when a patient ingests a pill is being touted as a way to tackle drug nonadherence. The so-called smart pill joins other new compliance strategies such as financial incentives for patients and game-like applications.

The strategies are the latest methods offered to physicians and others in health care to battle the perennial problem of patients not taking their medicines, which adds billions of dollars to U.S. medical costs annually.

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A quality improvement effort involving nearly 150 hospitals in 16 U.S. communities is boasting reduced readmissions, improved emergency care and better adherence to care standards.

The Robert Wood Johnson Foundation’s Aligning Forces for Quality began in 2006 with four pilot sites and now has health care partners in communities across the nation, such as Humboldt County, Calif., and Memphis, Tenn. Hospitals participating in the project’s Hospital Quality Network, which started in 2010, took part in monthly conference calls to share best practices with one another and learn to implement strategies shown to work in other organizations.

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Hospitals reported only 8% of the adverse events that they were required to share with state authorities, said a July study from the Dept. of Health and Human Services’ Office of Inspector General.

Twenty-five states and the District of Columbia have adverse-event reporting systems, although the reporting requirements vary by state. Of 35 adverse events the OIG had identified previously in these states, only three were submitted to a state reporting system. The OIG found that only one Maryland hospital had internal reporting of an adverse event — excessive bleeding that prolonged a patient’s hospital stay — and did not report it when required.

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The vast majority of hospitals provide an incomplete picture of the costs, risks and benefits of robot-assisted gynecologic surgery on their websites, said a study in July’s American Journal of Obstetrics and Gynecology.

Researchers examined the websites of 432 hospitals with 200 or more beds in six states and found that 44% had content relating to robotic gynecologic surgery. Nearly two-thirds used stock images from the robotic device’s manufacturer, Intuitive Surgical Inc., and 24% used text from the company.

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Newly published research reveals a mixed picture regarding the quality of care that low-income patients can expect as health system reform moves ahead after the Supreme Court’s June decision on the Affordable Care Act.

The flood of newly insured patients — about 30 million during the next decade, according to a July Congressional Budget Office estimate — probably will strain a health system that the Assn. of American Medical Colleges says will see a shortage of 160,000 physicians by 2025. The CBO estimates that 11 million of the newly insured will be covered by Medicaid, though that number could be substantially higher if more states decide to accept the federal government’s plan to expand eligibility for the program.

Beyond the work force issue, there is the broader question of where these patients — and the 30 million the CBO expects to remain uncovered by the law — will seek care and what caliber of care they will get. Some experts argue that federal pay-for-performance efforts could exacerbate the financial squeeze felt by the health care organizations that traditionally have delivered care to the poor.

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In the name of patient safety, some hospitals require that senior physicians get a fitness-for-duty evaluation as a condition of medical staff privileges.

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Nearly two-thirds of surgeons are unwilling to honor a patient’s request to end life support after operating on that patient, and they are less willing to do so when a surgical error occurs, said a study in Annals of Surgery in July.

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