Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly. Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (âcold turkeyâ), and leg movements.
1. Congestive heart failure (Statistical Brief #142, 2009 data) â The mean cost per CHF readmission is $13,000, with a 25.1 percent readmission rate. This is 118 percent the cost of an initial admission for CHF, which costs $11,000 on average.
Instead of the 2.9 percent in LTACH payment rates that CMS had proposed in January, 2004, the actual increase will be 3.1 percent. This translates to a standard payment of $36,762.24 per Medicare discharge, up from $35,726.18 in 2004. Moreover, in January, CMS had proposed an increase in the fixed loss amount (the amount of losses the provider must absorb before it becomes eligible for high-cost outlier payments) from $19,590 to $21,864. In fact, the fixed loss amount, effective July 1, 2004, will be reduced to $17,864.