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Emergency Care for Heart Attacks, Pneumonia Fails to Meet Goals

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As many as 22,000 preventable deaths occur each year in the United States because emergency departments across the country aren't meeting national goals in treating heart attack and pneumonia patients, according to a Johns Hopkins study.

The researchers looked at the records of 1,492 heart attack and 3,955 pneumonia patients treated at 544 emergency departments (ED) between 1998 and 2004. They found only 40 percent of eligible heart attack patients received recommended aspirin therapy, and only 17 percent received recommended beta blocker treatment. Among pneumonia patients, only 69 percent received recommended antibiotics, and 46 percent had blood oxygen levels assessed, as recommended by the American Thoracic Society.

"If these numbers are applied nationwide, we estimate that as many as 22,000 deaths a year could be prevented in the U.S., if ED caregivers followed practice standards," principal investigator Dr. Julius Pham, an assistant professor of medicine in the Johns Hopkins departments of emergency medicine and anesthesiology and critical care medicine, said in a prepared statement.

"More resources should be directed at studying why this is happening and developing strategies to ensure that 100 percent of patients get the recommended treatments," Pham said.

The Hopkins team also identified "troubling" racial, geographic and financial differences in heart attack and pneumonia patients' access to recommended care. For example, white heart attack patients were 40 percent more likely than non-whites to receive aspirin therapy. Patients in the Northeast were much more likely to receive aspirin therapy than those in the West.

Patients treated in government hospitals (state or country) were less likely to receive recommended treatment, while those with private insurance were consistently more likely to receive appropriate care.

The study was published in the October issue of Academic Emergency Medicine.
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