Hospitals also face financial failure, since new health care law withholds some funds for bad care
Article Source: msnbc.com
from:msnbc.comWorst hospitals treat larger share of poor, says study
Seeded on Wed Oct 5, 2011 4:19 PM EDT (msnbc.com)
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Makes no sense, take away money from the hospitals that need it most as "punishment"? It's like the whole NCLB practice of punishing poor performing schools by withholding money. How can they treat or teach better with less???
Drew Medical Center in LA. A janitor mopped around a patient that died on the floor in the ER.
Bad performing hospitals should be punished for hiring losers let them be Dr's or janitors.
youve got to be really careful here
these hospitals also have the sickest population with the most comorbidities....their "pneumonias" are much different that other "pneumonias". ITs not apples and apples...its the whole problem with the government paying for performance. Its a very difficult thing to measure
Nobody in D.C. knows what they are doing. More than one legislator has said that the bottom 10% or so of hospitals, based on nebulous outcomes ought to be closed down. If that happens think about how many hospitals will be shut down in 5 years. One of their definitions of bad outcome is a patient who has to be readmitted within a certain period of time with the same disease. The flaw in this logic is that a poor person who is only on Medicare cannot afford the medicines that might keep them out of the hospital...and believe it or not, there are some truly poor who cannot even read the directions on the pill bottles much less follow the discharge instructions they are given at the hospital. Many of them in rural areas cannot even get to a hospital except by calling an ambulance. This is a problem created in D.C. by ignorant people of both parties. We need to get our priorities straight. It costs $800,000 a year to maintain a single foot-soldier overseas. Bring them home and quit fighting these stupid wars and use the money to help our own citizens.
That's the Republican way!
Well if you say so but it was the Democrats Health Legislation....
BNo the Democrats planned it and voted it in over the will of the people
Not all people pick hospitals by their home - some of us are smart enough to pick a hospital based on who is best for the services we need. Consumers are much smarter than you are giving them credit.
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There are factors other than the quality of hospital care that affect patient outcomes. Indigent patients frequently delay going to the hospital until their problems are more severe and thus more difficult to treat successfully. It is difficult to devise a hospital payment system based on outcomes that does not punish hospitals for trating the poor.
excellent point!
Ive worked in some of these hospitals and old bill is exactly right
The Government needs to keep away from my healthcare.
Good lord they go through all this trouble to pass bad health care legislation and go figure it penalizes the elderly, poor and minorities...what were the Democrats thinking. Who exactly are the planning to serve with all the penalty they are placing on working people?
Easy answer, the insurance companies just as it was planned from the beginning.
Obamacare was not finished when it was passed in the middle of the night.
The Democrats did that because the Senator from Mass that won Kennedy's seat was GOP and was about to tilt the vote against the Seante approving the bill
People who end up in these under-performing facilities might benefit from a stronger provider/patient relationship in which more time is spent with them to explain treatments, drug options and lifestyle changes. Follow through is key. Care must continue after the hospital visit, the patient given clear guidelines to take care of their health and the providers adequately reimbursed so there is incentive to keep their patients healthy.
http://whatstherealcost.org/video.php?post=five-questions
"Worst hospitals treat larger share of poor, says study "
Do ya' think?...
Just wait, Occupy Wall Street is coming to a town near you.
Hope they do so they can be chased out by a mob of real americans
Welcome to socialist Obamacare where every hospital will be one of the worst hospitals
This is a complex issue. I'm a surgeon that worked in a government hospital for several years and am now in a private practice in a wealthy community. My results at the govt job were far worse, though I worked at least as hard and was very dedicated to my patients. Why? Because the patients were so much sicker to begin with, and, similarly, they often presented with their disease in a far more advanced stage, when treatment is less likely to succeed. We need to bear this in mind when we evaluate hospitals: those most dedicated to the sickest people may look bad. There's economics involved, too: those docs that take on only healthier patients make more bucks and look better results-wise, but is that what it's about?
I agree that on paper, Dr's that routinely take care of the sickest patients do look bad. In my opinion, the biggest reason that we need some sort of healthcare reform is to make healthcare available. Routine everyday healthcare is the backbone to good healthcare. Until the poor and the elderly can afford to see a doctor as often as their health dictates, we will continue to have these problems.
I also believe that hospitals should be nonprofit. As stated in the srticle, the best-rated hospitals are non-profit AND have the lowest prices. Doctors and nurses need to be paid for their services. But the hospital's first priority should be patient care and not how to make another buck by charging outrageous hospital fees
RightO Doc! After almost 30 years on the front lines of patient care in an acute care hospital I know the story. A lifetime of bad health habits along with a lack of insurance, education and motivation and you get the 55 y/o 300 pounder with a 20% ejection fraction, claudication and diabetes. Now go to it Doc, cut away...
Paddleboard is right. When stockholder get involved in how a hospital is run the quality of care takes a back seat to profits. The best hospitals are non-profit and run by doctors acting as administrators (like the Cleveland Clinic). In fact, the Cleveland Clinic and Mayo and several other prominent groups with great reputations have declared they will not participate in the current government healthcare system.
Wait... didn't we try a similar policy already? Giving less money to the institutions that need it most? Oh right, I remember. No Child Left Behind. Equally as effective!
I was thinking the same thing. This is the healthcare equivalent of "No Child Left Behind".
apparently they are going to keep beating that dead horse of an idea
It really irks me that Medicare will not agree to release the names of the "worst" hospitals. Yeah, I can see not sinking them, but the public has a right to know if the hospital they rely on is going to be a bad bet!!!
The point is that the hospital is considered a 'worst' hospital based on current measurements. They are looking at metrics that will always look bad in certain environments.
These hospitals have a population of people that have a difficult time, for whatever reason, with compliance when they leave the hospital. So if they return within 30 days, for whatever reason, the hospital gets dinged for that. If a patients has a successful open heart surgery, goes home, then falls 3 weeks later and breaks a leg (no matter the reason) and has to come back to the hospital, that goes against the hospitals outcomes and lowers the hospitals ratings. So imagine, you have a patient that comes to the hospital because they have no primary care physician, for whatever reason, then they come back to the hospital in two weeks, then in one week, then in one month, and repeatedly, for whatever reason (didn't take meds, no transportation, poor lifestyle choices, etc.), the hospital takes a ding.
Outcomes for hospitals need to be revamped. I don't have particular answers, but the way they are measured now, truly measures compliance of the patients more so than the competence of the hospital.
And Obamacare strikes again.......
Washington doesn't understand that you cannot possibly make health care better and cheaper while health insurance companies are allowed to do what they do. Any sort of health care reform that doesn't address for profit health insurance companies' tactics is laughable.
Compliance for many of these patients is already poor. Now that they know that Obama has made health care a 'right', compliance is only going to get worse resulting in worse outcomes, as they are measured now.
The population thinks they can live their lives however they choose, it's a 'free' country, right? Then they are told that they have a 'right' to health care. So, they will live it up and run to the ED when they need 'fixing'. Won't follow discharge instructions, no matter how much education and assistance they receive. Won't follow up with primary care visits. Won't adopt any lifestyle changes. Then, the hospital and all of its hardworking employees will be punished because the public wants to live a 'free' life and not be told what to do.
Saw it coming. It will get much worse, before, if ever, it gets better.
Another regulation to perpetuate class warfare. Joy!
Maybe someone should address the idea that certain groups of people tend to have unhealthy habits and ask why and what can be done to improve it?
It is constantly being done. Transportation to and from doctor visits, free prescriptions for a year, constant community education and free clinics. I'm telling you, the problem is a very big lack of personal responsibility for one's own health. People do not like being told how to live their lives. They just want someone to 'fix' them so that they can get out of the hospital and get on with their lives.
It needs to be a two way street. AND, the hospital is only ONE step in the entire health care process.
This article, and what I can find out about the study elsewhere, is sketchy at best. It states overall percentages, not specific percentages. It would be good to know the % outcome for the specific groups (elderly, black, medicaid, hispanic, etc.) for each hospital. If it is true (as previous studies indicate) that these subgroups are higher risk, then it is expected that hospitals with a lower % of such patients would have overall better outcomes. But if one looks at each subgroup separately, and take a % from only that specific group, we may find that the hospitals are pretty much the same. Perhaps. Perhaps not. The article doesn't provide clear data, but it looks like something is missing.
What I don't see mentioned, is while the hospital may be rated low, it's the ONLY hospital in town. For instance, the closest Level 1/Level 2 trauma centers are an hour away from my home.
The same here. I was in a car wreck in YR 2000. I would not be alive today if it was not for the air ambulance.
I hope the government didn't pay very much for this study.