Skip to comments.Is The Current Recession Compromising Hospital Quality?
Posted on 06/11/2010 1:10:15 PM PDT by BossLady
During past recessions, the financial stability of hospitals seemed to be nearly indestructible. But researchers at the University of Michigan Health System and St. Joseph Mercy Health System say the current national economic crisis may be an exception.
Hospitals are reporting declining profits, likely as a result of Americans losing health insurance as they lose jobs. As a result, hospital plans for renovation and new construction are being scrapped, and hospitals are being forced to reduce hospital staff, according to an analysis in the just-released May/June issue of the Journal of Hospital Medicine.
The researchers speculate hospital cutbacks may risk the quality and safety of health care delivery, and urge the federal government to improve public awareness of overcrowding emergency services, nurse-to-patient ratios and use of information technology.
"In uncertain economic times, it's especially important to have certainty that hospitals are doing things safely. But as hospitals reduce staff and make other changes to make ends meet, we don't necessarily have that certainty. That's why it's as important as ever to not only measure the quality of hospital care, but also understand the systems that do deliver consistent, cost-effective and high quality care." says lead author Jeremy Sussman, M.D., M.S., an internal medicine physician and Robert Wood Johnson Foundation clinical scholar at the University of Michigan Health System.
During this recession, every source of income for hospitals is at risk. Almost three-fourths report receiving less reimbursement from insurance payers per discharge and over half report a decrease in patient admissions, according to the American Hospital Association's report, "The Impact of the Economic Crisis on Health Services for Patients and Communities." In addition, more than half of hospitals report difficulty obtaining bonds - an important source for paying for new construction or big-ticket equipment purchases - and charitable donations are down.
Though this is a difficult time for hospitals and many other organizations across the country, the authors say this is a critical time to improve monitoring of hospital quality. They encourage the federal government to increase public awareness of local medical needs, hospital financial stability and available patient services.
"We were surprised by how well hospitals have done during recessions in the last several decades and how, despite the economy in the last 12 months, relatively few hospitals are closing down. Instead, hospitals seem to be dealing with the economic crisis by reducing staff, scaling back or completely stopping new construction projects and implementing various efforts to improve efficiencies of care," says Sussman.
"Our primary concern is that hospitals are making decisions to hold off on improvements in infrastructure and technology and cut staffing in ways that lead to a decrease in quality of care," Sussman adds.
Cuts to hospital staffing can hurt interactions between health care providers and patients, threatening robust nurse-to-patient ratios, which have been shown to affect patient safety, he says.
Sussman and his coauthors suggest the federal government should focus on connecting hospital safety with financial stability. For example, a hospital could receive government stimulus funds to employ nurse discharge advocates - who educate and prepare patients for discharge with instructions for medications and follow-up - to reduce rehospitalization. This program would preserve employment while advancing patient safety.
"Quality of hospital patient care must not only be maintained, but needs to be advanced in the face of the current economic challenges," says Sussman. "By stressing the importance of continuous improvement and measurement of quality standards during this 'Great Recession,' we can help hospitals better care for patients today and also prepare for further economic stresses in the future."
Additional authors: Along with Sussman, Lakshmi K. Halasyamani, M.D., vice president for quality and systems improvement at St. Joseph Mercy Health System and Matthew M. Davis, M.D., M.A.P.P., associate professor of pediatrics and communicable diseases and internal medicine at the U-M Medical School and associate professor of public policy at U-M's Gerald R Ford School of Public Policy.
Journal reference: Journal of Hospital Medicine, Vol. 5, Issue 5.
Source - University of Michigan Health System
Article URL: http://www.medicalnewstoday.com/articles/191514.php
Come on now.....this makes way too much sense and we can't be having any of THAT kind of absurdity obstructing the Obama Agenda!
FedGov is not the fix, the FedGov is the PROBLEM.
Likely loss leader - Federal Emergency Medical Treatment and Labor Act AKA the Patient Anti-Dumping Law. WHen you are forced to give away your product, you are going to go under.
Wait till bammycare kicks in. They will be closing as many hospitals as banks....
I realize that....however, the article talks about grants that are already in place.
There's a hint of advocacy in the article. It indicates that "robust" nurse to patient ratios improve quality/safety. This has not been determined. A study of CA hospitals (operating with mandated ratios) revealed no such improvement (Welton). Another study of PA hospitals revealed an improvement, but that study was conducted by a nursing staffing advocate (Aiken).
Intuition may lead one to assume that the more nurses, the better. But the reality is: the better the nurse, the better the outcome.
The article also throws out ER overcrowding and "information technology". These are two faves of the nationalization crowd, although they have only marginal impacts on finances and quality. Not to say they can't and shouldn't be addressed, but they are not game changers.
Hospital losses in revenue are related in part to reduction in Medicare/Medicaid reimbursement.
The bottom line is....there is not enough money coming into many hospitals due to low insurance payments, therefore it DOES effect patient care.
There are also other factors such as....hospital administration/department heads and their ability to run an efficient staff on, often times....a shoestring budget.
I work on a ground level with many health professionals....and basically, they are overworked between trying to effectively treat patients, meeting regulatory perimeters and running their own practices.
It will be interesting to see what comes of this mess.
Diagnosis: 1-2 years Max
When they wheeled me in for surgery (kidney stone) there were seven people waiting there. It's absurd.
Nurses are the ones that keep patients alive. Doctors, interns and porters are generally there to help the nurses.
Are the nurses unionized?
No one is putting Nurses down. My point was that because of red tape involving hospital income and how it’s spent....there are a lot of issues that cause so many entanglements....no one can get anything done.
As far as costs go, while nurses do most of the work the MD's, interns and practitioners get the glory.
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