DRG monitor最新文献

Not every hospital should attempt to serve the senior market. For the right hospitals, it can be extremely rewarding, both professionally and financially. A hospital management team should be able to answer "yes" to most of the following questions if they want to proceed. Do 65+ persons exceed 12 to 15 percent of the population in your service area? A concentration of senior persons is required to provide a sufficient market for services. Are there organized groupings such as lifecare communities, adult communities, etc. within you service area? Marketing efforts can be targeted to these groups, including personal calls and special physician programs. Do you have physicians/groups that specialize in geriatric care? These groups provide the basis for quality care and will help promote the interest of other physicians in senior programs. Do you have strong cardiac, oncology, and orthopedic programs? These are the areas most often used by senior patients as they progress through their experiences with chronic illnesses. Do you have an aggressive and developing social work group? Social workers help locate patients in the service area, provide a basis for group activities, and outplace patients after a hospital stay. Is the volunteer group strong, populated with 50+ individuals and looking for more to do? Seniors are excellent emissaries in the community and they relate well to inpatient seniors who are often reluctant to interface with ill peers. Is your facility a low cost provider, i.e., can you break even or better on Medicare? Having a seniorcare program will obviously increase the Medicare numbers in the hospital census.(ABSTRACT TRUNCATED AT 250 WORDS)

Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40% of hospitals had predicted costs within plus or minus 5% of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated.

In order to meet the needs of a large elderly disabled population in the 1990s, the inevitable close linkage between the hospital and post-acute care providers will place increased demands and responsibilities upon the hospital management team and their hospital practicing physicians for patient care decisions along the continuum of care for the elderly.

The authors present a framework, derived from successful experience with an actual hospital turnaround, for helping hospital management to restructure costs quickly and strategically under the pressure of losses. The framework isolates structurally inefficient hospital overheads into four distinct categories and prescribes very different corrective actions for each of them. Application of the framework to bankruptcy is also discussed.

Measurement of the appropriateness and quality of medical care with "small area variation analysis" is examined in this report from a hospital in California.

Hospitals need the data that valid surveys can provide. However, no data are better than inaccurate or poorly interpreted data. Survey research appears to be deceptively simple. Many hospital managers are not sensitive to the pitfalls in writing a quality questionnaire and some who have their own personal computers believe that they can enter and tabulate the data. However, just as medical technology has advanced and become more complicated in recent years, survey research has also become more sophisticated during the past decade. The use of computers has assisted in the display of vast amounts of survey data, but interpretation is still the key to effective survey research. Many people can read the same table of data but come to different conclusions, depending on their point of view and their level of involvement with the issues being discussed. It is only human nature to interpret data to support what we believe to be the truth. Hospital managers should understand that interpretation of survey data is best done by neutral and skilled professionals who have worked closely with those who have authority to make costly decisions based on the results. A radiologist will tell you that reading a CT scan is an art as well as a science. So is quality survey research.

With the increased demand for care rendered in an ambulatory setting, hospitals are finding that they must reorganize their service complement and locations to keep up with market demand and respond to competitor initiatives. This issue of DRG Monitor describes an approach to determining what needs to be done, addresses factors that should be considered, and provides a model derived from a case study of a hospital. This approach goes beyond the tradition of viewing each department and/or service that offers ambulatory care as an entity unto itself. Instead, this paper illustrates how hospitals can look at the ambulatory components of departments and services from a product-line perspective so that they can maximize efficiency and link related areas in order to build upon their respective market potentials.

This issue of DRG Monitor reports on a recent study of strategic planning processes in public and voluntary, not-for-profit hospitals. The results of the study are used to evaluate the role of strategic planning in implementing recently introduced management concepts in health services institutions.

The study reported in this issue of DRG Monitor focuses on services provided by Directors of Pathology and was designed to characterize those services and to develop criteria to assist hospitals in assessing the appropriateness of their professional staffing in Pathology.