Using paramedics to help hospice patients avoid unwanted care

A novel way to help young men growing up in communities in which concentrated poverty, violence and unemployment are well-documented barriers to health and longevity: male youth of color are trained to be the emergency response team to help stabilize street victims before doctors or nurses begin procedures.

Improvements in CPR remain underused in practice, with many doctors giving up too soon. As a result, survival rates after cardiac arrest vary as much as 500 percent across the country.

Despite years of change, African Americans feel ostracized from the medical care community that is dominated mainly by white people, especially when it comes to hospices. Some are trying to remove the stigma of hospice care as well as make health care systems more fair.

A hospice patient's end-of-life desires are most often thwarted when well-meaning loved ones see the patient in some sort of distress. New programs ask first-responder paramedics to work with hospice programs to better honor a person’s end-of-life wishes.

The highest hospital costs come from preventable emergency room visits. A doctor in Camden developed a home visit program which gives better and cheaper care.

According to the Centers for Disease Control and Prevention, drug overdoses are the leading cause of injury-related mortality. Naxolone, a drug used to revive overdose victims, is only available by prescription. However, private organizations have distributed Naxolone kits nationally, showing that the drug can save lives when it is more readily accessible.

In Nepal, a controversial drug is proving to be effective in saving mother's lives. It's the only shelf-stable, easy-to-administer solution to curbing postpartum hemorrhage. In trials, misoprostol is shown to save the lives of women who live far from medical care facilities. Since Nepal allowed use of the drug, postpartum hemorrhage has fallen from the leading cause of maternal death to number two.

Residents who use a disproportionate amount of health care, or super utilizers, are a high cost for the system. A hospital in Baltimore is following the example of other hospitals and focusing on the underlying problems of super utilizers to reduce emergencies and save costs.

Social programs are seen as a fiscal burden on the U.S. However, investment in effective social programs saves taxpayer dollars so evaluating the performance of federal programs could help Congress act more responsibly.

Patients' last years of life are the most expensive for the health care system. For a fifth of the cost, a Zen hospice program, in San Francisco, is helping those who are dying improve their quality of death by enjoying the present.