Hospital Care in the United States, Commission on Hospital Care, New York, The Commonwealth Fund

PEDIATRICS ◽  
1950 ◽  
Vol 6 (1) ◽  
pp. 172-172
Keyword(s):  
New York ◽  
Hospital Care ◽  
The United States ◽  
Hospital Services ◽  
Source Book ◽  
American Hospital ◽  
American Hospital Association ◽  
Commonwealth Fund ◽  
Wide Range ◽  
Present Pattern

Many individuals and organizations have had a part in the making of this book. They have described influences and forces whose interaction has resulted in the present pattern of our hospital services, and documented their interpretations. The result is a source book of basic information which should be valuable for all students of hospital problems. The Commission was appointed by the American Hospital Association, and chosen to represent a wide range of those providing hospital, health and welfare services, as well as the consuming public.

scholarly journals Does Medicaid Broaden the Choices of Patients with Low Socioeconomic Status? An Analysis of Bypassing Behaviors in Brooklyn

2021 ◽  
Author(s):  
Jae Bok Lee
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
The United States ◽  
Difference In Differences ◽  
American Hospital ◽  
American Hospital Association ◽  
Low Socioeconomic ◽  
Statewide Planning ◽  
Improve Hospital

Abstract Background: Many governments worldwide have committed to extending choices in public service delivery. However, the extent to which policies ensure equity is unclear. We investigated whether Medicaid programs in the United States improve hospital accessibility among patients with low socioeconomic status, compared to those with non-low socioeconomic status who are non-Medicaid recipients or uninsured.Methods: We employed a difference-in-difference-in-differences approach using a rich dataset of information on inpatients and their choice of hospitals from Statewide Planning Research and Cooperative System and information on hospitals from the American Hospital Association in Brooklyn, New York, from 2003 to 2009Results: The findings indicated that Medicaid has failed to broaden the range of the hospital choices for patients with low socioeconomic status, assessed in terms of bypassing behaviors. Conclusions: Medicaid is a public program that offers choices driven by purchasing power. The findings of this study imply that this program has some limitations in alleviating existing socioeconomic inequities in available hospital choices.

scholarly journals Does Medicaid Broaden the Choices of Patients with Low Socioeconomic Status? An Analysis of Bypassing Behaviors in Brooklyn

2021 ◽  
Author(s):  
Jae Bok Lee
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
The United States ◽  
Difference In Differences ◽  
American Hospital ◽  
American Hospital Association ◽  
Low Socioeconomic ◽  
Statewide Planning ◽  
Improve Hospital

Abstract BackgroundMany governments worldwide have committed to extending choices in public service delivery. However, the extent to which policies ensure equity is unclear. We investigated whether Medicaid programs in the United States improve hospital accessibility among patients with low socioeconomic status, compared to those with non-low socioeconomic status who are non-Medicaid recipients or uninsured.MethodsWe employed a difference-in-difference-in-differences approach using a rich dataset of information on inpatients and their choice of hospitals from Statewide Planning Research and Cooperative System and information on hospitals from the American Hospital Association in Brooklyn, New York, from 2003 to 2009ResultsThe findings indicated that Medicaid has failed to broaden the range of the hospital choices for patients with low socioeconomic status, assessed in terms of bypassing behaviors. ConclusionsMedicaid is one public program that offers choices driven by purchasing power. The findings of this study imply that this program has some limitations in alleviating existing socioeconomic inequities in available hospital choices.

Analysis of Hospital Resource Availability and COVID-19 Mortality Across the United States

2021 ◽  
pp. E1-E4
Author(s):  
Alexander T Janke ◽  
Hao Mei ◽  
Craig Rothenberg ◽  
Robert D Becher ◽  
Zhenqiu Lin ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
New York Times ◽  
General Medicine ◽  
The United States ◽  
American Hospital ◽  
American Hospital Association ◽  
Hospital Referral ◽  
Hospital Resources ◽  
The Impact

While the impact of coronavirus disease 2019 (COVID-19) has varied greatly across the United States, there has been little assessment of hospital resources and mortality. We examine hospital resources and death counts among hospital referral regions (HRRs) from March 1 to July 26, 2020. This was an analysis of American Hospital Association data with COVID-19 data from the New York Times. Hospital-based resource availabilities were characterized per COVID-19 case. Death count was defined by monthly confirmed COVID-19 deaths. Geographic areas with fewer intensive care unit (ICU) beds (incident rate ratio [IRR], 0.194; 95% CI, 0.076-0.491), nurses (IRR, 0.927; 95% CI, 0.888-0.967), and general medicine/surgical beds (IRR, 0.800; 95% CI, 0.696-0.920) per COVID-19 case were statistically significantly associated with greater deaths in April. This underscores the potential impact of innovative hospital capacity protocols and care models to create resource flexibility to limit system overload early in a pandemic.

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

THE PRESIDENT'S PAGE

PEDIATRICS ◽  
1951 ◽  
Vol 8 (2) ◽  
pp. 275-276
Author(s):  
PAUL W. BEAVEN
Keyword(s):  
Public Health ◽  
New York ◽  
School Health ◽  
News Letter ◽  
American Hospital ◽  
American Hospital Association ◽  
Contagious Diseases ◽  
National Foundation ◽  
Health Laws ◽  
Infantile Paralysis

I AM SURE that the majority of our members are not aware of the influence of the Academy in public health and child welfare. For this reason I will recount some of the incidents that have occurred in the past few months which illustrate this. In May, Dr. Edward Davens, representing our Committee on School Health, went to a meeting in Washington arranged by the National Educational Association to examine the real meaning of citizenship in our country. Excerpts from his report will be published in the News Letter. Last January, Dr. Reginald Higgons attended a conference on school health in Cleveland, which he reported in full to the Executive Board and which will appear in the agenda of committees published in Pediatrics. I would commend this to anyone interested in school health work. In April, Dr. Stewart Clifford used the report of this same School Health Committee, of which Dr. Thomas Shaffer is Chairman, to modify the school health laws in Massachusetts to conform to its recommendations. If members in states are attempting to introduce modern practices in school health, they are referred to the central office. Dr. Christopherson will be glad to send them a copy of Dr. Shaffer's report. In February, Dr. Danis' Committee on Hospitals and Dispensaries sent representatives to a meeting in New York, called to discuss the care of contagious diseases in a general hospital. This group represented many organizations, including the American Public Health Association, the American Medical Association, the American Hospital Association, the American Nursing Association, and others. It was financed by the National Foundation for Infantile Paralysis.

Abstract 23: Incidence of Adult In-Hospital Cardiac Arrest in the United States

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Mathias J Holmberg ◽  
Catherine Ross ◽  
Paul S Chan ◽  
Jordan Duval-Arnould ◽  
Anne V Grossestreuer ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Arrest ◽  
The United States ◽  
Annual Incidence ◽  
Adult Patients ◽  
Negative Binomial Regression Model ◽  
American Hospital ◽  
American Hospital Association ◽  
Average Annual Incidence ◽  
Hospital Cardiac Arrest

Introduction: Current incidence estimates of in-hospital cardiac arrest in the United States are based on data from more than a decade ago, with an estimated 200,000 adult cases per year. The aim of this study was to estimate the contemporary incidence of in-hospital cardiac arrest in adult patients, which may better inform the public health impact of in-hospital cardiac arrest in the United States. Methods: Using the Get With The Guidelines®-Resuscitation (GWTG-R) registry, we developed a negative binomial regression model to estimate the incidence of index in-hospital cardiac arrests in adult patients (>18 years) between 2008 and 2016 based on hospital-level characteristics. The model coefficients were then applied to all United States hospitals, using data from the American Hospital Association Annual Survey, to obtain national incidence estimates. Hospitals only providing care to pediatric patients were excluded from the analysis. Additional analyses were performed including both index and recurrent events. Results: There were 154,421 index cardiac arrests from 388 hospitals registered in the GWTG-R registry. A total of 6,808 hospitals were available in the American Hospital Association database, of which 6,285 hospitals provided care to adult patients. The average annual incidence was estimated to be 283,700 in-hospital cardiac arrests. When including both index and recurrent cardiac arrests, the average annual incidence was estimated to 344,800 cases. Conclusions: Our analysis indicates that there are approximately 280,000 adult patients with in-hospital cardiac arrests per year in the United States. This estimate provides the contemporary annual incidence of the burden from in-hospital cardiac arrest in the United States.

Are nurses still practicing coronary precautions? A national survey of nursing care of acute myocardial infarction patients

1996 ◽  
Vol 5 (2) ◽  
pp. 91-98 ◽  
Author(s):  
B Riegel ◽  
T Thomason ◽  
B Carlson ◽  
I Gocka
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Temperature Measurement ◽  
Rectal Temperature ◽  
Valsalva Maneuver ◽  
The United States ◽  
American Hospital ◽  
American Hospital Association ◽  
Survey Techniques ◽  
The 1960S

BACKGROUND: Coronary precautions were common when coronary care units were instituted in the 1960s. However, research has failed to provide evidence of the validity of most of these restrictions. Only the avoidance of the Valsalva maneuver is clearly indicated as a universal precaution in patients who have experienced acute myocardial infarction. OBJECTIVES: To determine if nurses continue to restrict iced and hot fluids, caffeine, rectal temperature measurement, and vigorous back rubs, and to feed and mandate bedrest for acute myocardial infarction patients. METHODS: Survey techniques were used to describe practice patterns of nurses working in hospitals across the United States. Two sampling methods were used to access a random sample. The survey was mailed to members of the American Association of Critical-Care Nurses and nonmembers working in a hospital accredited by the American Hospital Association and with an intensive care unit. RESULTS: Of the 2549 mailed surveys, 882 were returned with usable data (34.8% response rate). Iced (28.1%) and hot (8.7%) fluids continued to be restricted by nurses. Most (85.6%) restricted stimulant beverages such as coffee. Rectal temperature measurement was avoided by 55.7%, and only 73.3% taught avoidance of the Valsalva maneuver. In terms of rest, 15.6% reported avoiding vigorous back rubs, 8.4% still fed patients, and 33.8% offered bedpans to pain-free patients on the first day after admission. A complete bedbath was offered by 19.8% of nurses to stable, pain-free patients even a day after admission. CONCLUSIONS: The data supporting liberalization of coronary precautions have not been adequately disseminated.

scholarly journals STRENGTH IN AGE-FRIENDLY HEALTH SYSTEMS: AN INNOVATIVE INTEGRATED INTERPROFESSIONAL MODEL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S829-S829
Author(s):  
Teri Kennedy
Keyword(s):  
Older Adults ◽  
Health System ◽  
Baby Boomers ◽  
Health Systems ◽  
Adult Population ◽  
The United States ◽  
Essential Elements ◽  
Conceptual Approach ◽  
American Hospital ◽  
American Hospital Association

Abstract This paper presents an innovative conceptual approach to health care policy for older adults: the Age-Friendly Health Systems Integrated Interprofessional Model. In 2017, the John A. Hartford Foundation and Institute for Healthcare Improvement, in partnership with the American Hospital Association and Catholic Health Association of the United States, advanced the concept of an Age-Friendly Health System. This initiative is designed to respond to the needs of a burgeoning U.S. older adult population, expected to double from 2012 to 2050, largely due to the aging of Baby Boomers and increased life expectancy. These Baby Boomers will demand a well-coordinated, communicative health system responsive to their values and preferences. In an Age-Friendly Health System, all older adults receive the best possible care, without care-related harms, and with satisfaction of care received. Essential elements include what matters, mentation, mobility, and medications, with a focus on patient-directed, family-engaged care. While a solid framework for improving healthcare for older adults, this model is further strengthened by incorporating the essential elements of person-, family-, and community-centered approaches to care; interprofessional team-based competencies, and Quadruple Aim outcomes. This enhanced model, referred to as the Age-Friendly Health System Integrated Interprofessional Model, combines elements essential to quality healthcare within the framework of an Age-Friendly Health System. This paper will present the original Age-Friendly Health System framework, the proposed Age-Friendly Health System Integrated Interprofessional Model, then compare and contrast each model’s essential principles. Implications for adoption of this enhanced model for policy, education, and practice will be explored.

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