“Managing Health Care in China and Taiwan”

The School of Public Health is presenting a lecture by Victor H.C. Chang, M.D., M.B.A., Chief Executive Officer, Landseed International Medical, Shanghai, China, and Taoyuan, Taiwan.

The Landseed International Medical group owns four hospitals in Taiwan. Since 2001 Landseed has operated a joint-venture medical facility in Shanghai and a health management consultancy, serving over 200 health facilities across China. In June 2012,
it opened the Shanghai Landseed International Hospital, the first Taiwanese wholly owned hospital in China.

  • Date:  Wednesday, April 10
  • Time:  5:00 – 6:30pm
  • Location:  1690 SPH 1 (Lane Auditorium)

Supplies and devices are biggest cause of hospital cost increases

From the AHRQ Newsletter:

Medical supplies and devices represented nearly one-fourth (24.2 percent) of rising hospital costs between 2001 and 2006, according to a new AHRQ-funded study.    Among all types of hospital stays, the cost percentage impact for supplies and devices was nearly three times that of operating room services.  While rising inpatient costs are typically associated with imaging services such as computed tomography scans and magnetic resonance imaging, those services only contributed a 3.3 percent increase in the cost of an average hospital stay, the study found.   Because rising hospitals costs are an ongoing concern, payers and policymakers may want to explore the specific factors driving those costs and the factors associated with them, according to the study authors.  The study, “What Hospital Inpatient Services Contributed the Most to the 2001 to 2006 Growth in the Cost per Case?,” was published online in Health Services Research on September 4.


AHRQ Quality Indicators™ toolkit for hospitals

The AHRQ Quality Indicators™ Toolkit for Hospitals is a free set of tools designed to support hospitals in assessing and improving the quality and safety of care they provide: http://www.ahrq.gov/qual/qitoolkit.

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) are measures of hospital quality and safety drawn from readily available hospital inpatient administrative data. They include:

Hospitals across the country are using the IQIs and PSIs to identify potential concerns about quality and safety and track their performance over time.

The QI Toolkit supports hospitals that want to improve performance on the IQIs and PSIs by guiding them through the process, from the first stage of self-assessment to the final stage of ongoing monitoring. The tools are practical, easy to use, and designed to meet a variety of needs, including those of senior leaders, quality staff, and multistakeholder improvement teams.

Read more here.

Health insurance, health costs–Who pays what & why

Two interesting stories in the New York Times.  “Insurers Alter Cost Formula, and Patients Pay More” discusses how the settlement of a case against health insureres in New York State has led to greater, not lesser costs to patients.

Despite a landmark settlement that was expected to increase coverage for out-of-network care, the nation’s largest health insurers have been switching to a new payment method that in most cases significantly increases the cost to the patient. . . .

The agreement required the companies to finance an objective database of doctors’ fees that patients and insurers nationally could rely on. Gov. Andrew M. Cuomo, then the attorney general, said it would increase reimbursements by as much as 28 percent.

It has not turned out that way. Though the settlement required the companies to underwrite the new database with $95 million, it did not obligate them to use it. So by the time the database was finally up and running last year, the same companies, across the country, were rapidly shifting to another calculation method, based on Medicare rates, that usually reduces reimbursement substantially. 

To read the complete article, click here.

“The Confusion of Hospital Pricing” on the Well blog describes how even people with good health insurance can end up paying tens of thousands of dollars for hospital care.

When Augie Hong awoke with severe abdominal pain nearly two years ago, he went to the hospital emergency room closest to his home in San Francisco. The diagnosis was acute appendicitis, and doctors removed his inflamed appendix.

Mr. Hong had health insurance, so he wasn’t too worried about paying. Then the bills started to arrive.

“That’s when I got nervous,” said Mr. Hong, 36, who has insurance through his job at an investment firm.

In all, Mr. Hong was charged $59,283, including $5,264 for the doctors. According to the Healthcare Blue Book, that amount is six times the fair price for an appendectomy in Northern California, which is $8,309 (including a four-day admission) for the hospital and an additional $1,325 for the doctor. Even after Mr. Hong’s insurer paid the hospital $31,409 and Mr. Hong paid the doctors $4,034, the bills kept coming.

A new study suggests that Mr. Hong’s experience is not unusual. Hospital charges are all over the map: according to the report published Monday in the Archives of Internal Medicine, fees for a routine appendectomy in California can range from $1,500 to — in one extreme case — $182,955. Researchers found wide variations in charges even among appendectomy patients treated at the same hospital.

To read the complete article, click here.

April 27 Web Conference to Explore Strategies to Reduce ED Crowding, Improve Patient Flow

With nearly half of all emergency departments (ED) operating at or above capacity and the majority of hospitals holding patients in the ED while they wait for an inpatient bed, hospitals are seeking ways to reduce ED crowding. A Web conference sponsored by the Health Research & Educational Trust, an affiliate of the American Hospital Association, will discuss steps for implementing strategies that hospital leaders can use to reduce ED crowding by improving patient flow. These steps are outlined in a recent Agency for Healthcare Research and Quality funded publication, Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals. They include: forming a patient flow improvement team, measuring ED performance, selecting and implementing the right policies to improve patient flow, and address implementation challenges.

The free Web conference will be held at 3:00 p.m. ET on April 27. Register here. For more information on the AHRQ-funded ED Guide, click here.

Medicare Hospital Quality Reporting

From HealthAffairs:

A just-released study raises questions about Medicare’s seven-year public reporting initiative for hospitals, Hospital Compare.  The study indicates that Hospital Compare had no impact on reducing death rates for two key health conditions and just a modest effect on a third.

Authors found that hospitals might have improved on thirty-day mortality rates during the study, but attribute the change to ongoing innovations in clinical care, and not to any effect related to public reporting.  At the same time, the researchers found a modest improvement in mortality rates for heart failure; though, they can’t prove that this was related to the public reporting initiative.

See the full article here:  Medicare Hospital Quality Reporting.

Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report

The Agency for Health Care Research and Quality (AHRQ) has released the Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report.  Based on data from 1,128 U.S. hospitals, the report provides initial results that hospitals can use to compare their patient safety culture to other U.S. hospitals. In addition, the 2012 report presents results showing change over time for 650 hospitals that submitted data more than once. The report consists of a narrative description of the findings and four appendixes, presenting data by hospital characteristics and respondent characteristics for the database hospitals overall and separately for the 650 trending hospitals.

Download print version (Part 1, PDF File, 1.8 MB; Parts 2 and 3, PDF File, 1.6 MB).  Click here to read more.