Healthcare in Delaware (buyer, professionals, fence)

[peeweeaz]

rockky,

If you lived here in Fountain Hills, the sales tax is between 9-10 percent. The overall Arizona sales tax is the same as MD - 5 percent. But the counties can then jump on. I live in Maricopa County, home of the country's tougest sheriff, Joe Arpaio. Tent city, pink underwear and green baloney sandwiches for offenders. BTW the state just passed a new DUI law. First time offenders (.08) have to have a breathylizer ignition switch that costs $100.00 to put in and $80.00 per month to maintain. Is this a great country or what?? Don't ask me why I got off topic. I think I had a senior moment. I agree with you that it pays to travel to DE to shop for large purchases. For example, if I bought a TV here for $2,000.00, it would cost me close to $200.00 in sales tax. DE would cost zilch.

Bob

[elizamary]

Originally Posted by peeweeaz

rockky,

If you lived here in Fountain Hills, the sales tax is between 9-10 percent. The overall Arizona sales tax is the same as MD - 5 percent. But the counties can then jump on. I live in Maricopa County, home of the country's tougest sheriff, Joe Arpaio. Tent city, pink underwear and green baloney sandwiches for offenders. BTW the state just passed a new DUI law. First time offenders (.08) have to have a breathylizer ignition switch that costs $100.00 to put in and $80.00 per month to maintain. Is this a great country or what?? Don't ask me why I got off topic. I think I had a senior moment. I agree with you that it pays to travel to DE to shop for large purchases. For example, if I bought a TV here for $2,000.00, it would cost me close to $200.00 in sales tax. DE would cost zilch.

Bob

Oh, I love green baloney

[Charley]

A few weeks ago, I posted the link to a 46 page report on Delaware hospitals. I printed it out that night (and of course it was more like 59 pages ... lol). I finally finished my review of that report.

I looked for anything that was statistically distinct. In other words, I looked at all the data and compared hospital to hospital, and hospital to national data provided in the report. I found that in many cases, the data from Delaware actually exceeded the national standards, which is a good thing.

The only major (in my opinion) statistical issues that I found were the following:

In the case of Postoperative Respiratory Failure, Bayhealth in Dover reports 4 episodes per 1000 cases. which puts them below the national average of 2.1 episodes per 1000 cases. (Christiana reported 1.3 cases/1000, Beebe in Lewis reported 1.1/1000 and Nanticoke in Seaford reported none.)

In the cases of Postoperative Sepsis (infection), Christina reported 14 per 1000 cases and Nanticoke reported 14.9/1000, both over the national average of 9.2/1000. Bayhealth was 6.3/1000 and Lewes was 6.8/1000.

In all the statistics provided in 59 pages, those were the only two negatives. Most other data was either equal to or better than the national standards.

Therefore, from an INPATIENT HOSPITAL viewpoint only, I'm willing to say that based on all that I have seen so far, there is no statistical difference in the patient outcomes in the Delaware hospitals as compared to the national averages. This does not address outpatient departments, emergency rooms, doctors offices, insurance companies, or anything else, which I also want to research. This speaks just to the hospitals themselves.

By the way, all negative incidents and occurences must be reported by hospitals. In New York, if a hospital fails to report and the state or the feds find out, the penalties are quite severe, including the potential loss of Medicare / Medicaid funding, which essentially closes the doors. So it is my assumption that the reporting done by the Delaware hospitals is at least as accurate as any other state.

Charley

P.S. On a personal level, I know that at some point, I will need a total knee replacement. Christiana does 613 a year, Bayhealth does 225 a year and Beebe does 244 a year. I'll go with the experience and have it done at Christiana. The doctor's skill is one issue, but the experience of the OR staff and the nursing staff are to be considered as well.

[zarabeth]

Gee, wish I had seen this post before.....I don't get on here much lately.

As I've said whenever I've seen a question on healthcare in Delaware....there's statistics and then there's reality.

Reality is, in southern Delaware, healthcare isn't the greatest.

Nanticoke Hospital didn't achieve JCAHO rating this year...they have a "conditional" approval only, pending next review....they're scrambling to make it. They're short of nurses, and both anesthesia and radiology physicians. Waiting times for treatment in their ER are unbelievably long; so is the wait for surgery, due to staff shortages. Most of the EMS crews divert anything other than a simple injury to Beebe(in Lewes) or Salisbury, Maryland.

There are many, many "creative" ways to make numbers and percentages look good.....the reality is something else again....we work there, so this isn't conjecture...it's firsthand knowledge.

Getting your knee done in Christiana is a much better decision, CMTAD. Just FYI, Beebe's program is good, too. They don't do as many cases, because the hospital simply isn't the size Christiana is; Christiana, recall, is the state's only Level One Trauma ssytem....it makes a difference.

[Charley]

Zarabeth,

Thanks for the added information.

I went back to the JCAHO site to double-check what I had originally posted about Nanticoke and cannot find any reference to conditional status. According to the site, Nanticoke did acheive full accreditation on December 10, 2005. In addition, they had an interim on site survey on October 19, 2006 and accreditation continued. They are also at or above the national standards for the National Patient Safety Goals and National Quality Improvement Goals.

Having worked in hospital administration for 29 years, I know what a facility can do to make it's numbers look better. But I also know that if a hospital gets conditional approval, as ours did once, it's on the JCAHO website.

I'm not doubting you. I'm just trying to figure out why the JCAHO site doesn't have it. Did it just happen? Did they walk in unannounced? Could the JCAHO site be wrong? I guess it's possible.

I do agree with you about Christiana, it's size, and it's level one designation and if the knee replacement is unavoidable, I would imagine Christiana is first choice.

Thanks again for the update. Please let us know how Nanticoke does in their next review.

Charley

[JulieF]

I like the way you seek the facts, Charley. That's the reasonable thing to do. And, once again, I have to point out that personal experience, over a number of years, especially when it's confirmed by many other family members and friends has to count for something. Many of our complaints (and horrors) do involve the ER, and you've said, I think (I'm rushing through again), that you haven't evaluated ER's at this point.

I think, for now, I'll back off this subject. I feel, can't help it, at least a little hostility directed my way, sometimes in the form of not responding to my posts (not only the medical ones, and not you, Charley). I miss many posts and just don't have the time to respond to some, and I'm sure some people on the board are in the same position. I do understand. I also understand that when you're trying to get to know your new home or the state you expect to move to, you really want to hear the good things. If you've lived anywhere for a long time, you may know quite a few unfavorable things, and realize that there are questionable areas when it comes to good things, even the loss of some of the good things, or the scarcity of good things, some important, some not quite so important. I have tried to highlight some of the best things in Delaware, its various towns and counties, and near Delaware as well. I'll continue to do so, but please believe me that when I look up and read about other states, cities, towns, I'm interested in the whole picture, good and not so good.

Wow, do I ramble on! We (family, friends) have found that we have to go beyond Christiana Hospital when it comes to really serious situations, though I hear that they are improving (cardiac and related) every day. I know of someone who had a very successful knee replacement surgery there. I don't know where she followed up with her therapy, but can tell you that a couple family friends have found Lifestyles, gym and follow-up physical therapy associated with Kent General (Bayhealth) and located right next to the hospital, to be excellent.

I'm promising myself to stay out of the medical and related threads, or at least not to respond to posts with this subject matter for a while! I will, of course, respond to a reply from you, Charley.

Lori

[Charley]

> I feel, can't help it, at least a little hostility directed my way, sometimes in the form of > not responding to my posts (not only the medical ones, and not you, Charley).

Hi Lori,

I just wanted to respond to this little piece of your message for a moment. There are many threads running through the Delaware forum and sometimes, it's hard to keep track of which conversation is happening in which thread. Even I get lost in it all sometimes and I can't imagine that the regular posters have any feelings of hostility toward you at all. I think it's possible that with all the cross-conversations happening here, that some messages just fall through the cracks.

I'm not making excuses for anyone. I just think that sometimes, it's a challenge to be able to be "up to speed" on the all the various conversations happening here. I'm sure that since you've shared your feelings with us, members will be sensitive to what you've said and perhaps go that extra step to try to respond to your messages.

Charley

[peeweeaz]

Lori,

I totally agree with Charlie. Because you work at home, I gather you don't have a lot of time to go meandering all over the place looking for responses to your posts. I apologize for that. Sometimes we get carried away and go off in all kinds of directions. And there are some folks, like myself, who are so computer stupid that they think a thread is something you put through the eye of a needle.

Addressing your other points about getting the big picture about a place,
as we roam through this forum we're going to see all kinds of positive and negative comments about health care, crime, housing, things to do, etc.
Someone once said, "Don't believe anything you read, and half of what you see." As individuals, we all have likes and dislikes; things that are important or not so important. The purpose of the legal term, "reasonable person" is to allow the law some flexibility when dealing will all types of persons. Having said that, as we read the comments on this forum we really have to know ourselves and what it is we want when changing locations. I've seen comments about what neighborhoods should be avoided because of crime, etc. That's kind of relative in that if I told someone in downtown Baltimore, Philly or Washington D.C. that we, in Fountain Hills, have a fair amount of property crime and youthful vandalism, they would look at me like I was nuts. Murders, drug dealing and other serious crimes are every day occurrences in these cities. Another case in point, Elizamary, who moved to Magnolia in February 2007, loves it. I can think of few negative comments she has had over the months (train station neighborhood comes to mind) On the other hand, a lady, whom I haven't seen in awhile, and whose poster name is Roxanne, lived most of her adult life in the Dover area and hated it. She couldn't wait to get out. Charley is doing it right. On issues that are important to him and others on the forum, he is looking at statistics and comments from other posters and making judgements that only he knows are important to him or not. He isn't in Delaware; therefore, he can't give his personal observations. (and you think you ramble I guess my point is to take everything you read with a grain of salt because the only sure way of knowing about a place is to go there and see for yourself. The comments in the forum are helpful, but not the whole picture.

[maryCh]

I haven't read all the pages of this thread, so my comment may be out in left field, but here's my 2 cents on the issue.

As everyone knows, healthcare in most places all over the US is going to he** in a handbasket. Even in the best facilities, more diligence is expected of the patient in keeping up with the big picture, as staff is short handed, overworked, etc. chasing the ever-loving insurance dollar. So the old saying of "time is money" is hitting healthcare from all sides.

So far, knock wood, we have not experienced too many major medical crises in my life. Even in NC, where we came from, the best facilities were the teaching hospitals (the closest to where we lived was over an hour away). So I counted my blessings we didn't need much "important" done in our 15 years there.

In NYC metro area, where hubby "lives" and works, you may have state of the art facilities, but the "best" are hard to get into. Hubby had a mild stroke 2 years ago, and thankfully it occurred at JFK so he went to a wonderful trama center that specialized in stroke victims. Now it was in a horrible area of Queens, so he was in good hands but anyone visiting went through some danger zones getting there.

I personally don't think (and I may be totally wrong, I'm only going on what I've read and our very short period of time here) the state of healthcare in DE, overall, is any worse than many other, mostly rural & light suburban areas.

Since our main focus was schools, as I posted on other threads, we were willing to roll the dice on the medical. So far, our experience has been leaps and bounds above what the kids and I experienced in NC. If any of us has a major problem, I may rescind my post!

Mary

[elizamary]

Originally Posted by JulieF

I think, for now, I'll back off this subject. I feel, can't help it, at least a little hostility directed my way, sometimes in the form of not responding to my posts (not only the medical ones, and not you, Charley). I miss many posts and just don't have the time to respond to some, and I'm sure some people on the board are in the same position.

I'm promising myself to stay out of the medical and related threads, or at least not to respond to posts with this subject matter for a while! I will, of course, respond to a reply from you, Charley.

Lori

Hi Lori...........I'm sorry if I fit that category of not responding. I have NO hostility toward you at all. Please believe this. I love reading your posts and look forward to the day when we can meet.
You come across as a sweet person

As far as the medical part goes, it is a little scary for the us who just moved down because I have heard some horror stories too.
But in reality, this sort of thing is happening all over. Like Mary said, Health care is going to Hxxx in a hand basket. I think I said that before too in one of my other posts a while ago.
It is not just DE but all over the U.S. of A.
I heard horror stories in Philly.
But
Please dont' stop sharing your experiences. We all need to hear them.