scholarly journals An Investigation of Economic Efficiency in California Hospitals

2017 ◽  
Vol 6 (1) ◽  
pp. 30-51
Author(s):  
Kathryn Chang ◽  
Gene H. Chang
Keyword(s):  
Economic Efficiency ◽  
Acute Care Hospital ◽  
Hospital Performance ◽  
Performance Outcomes ◽  
Public Hospitals ◽  
Care Hospital ◽  
Ownership Type ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Managerial Implications

ABSTRACT This paper investigates variations in hospital behaviors and performance outcomes due to ownership type. Conventional economic theory predicts economic efficiency benefits from for-profit control type; however, a broad review of hospital performance literature provides empirical evidence that primarily favors nonprofit hospitals. This paper extends a theoretical model of nonprofit hospitals and develops hypotheses that predict nonprofit hospitals perform better in terms of price, cost, and service volume when compared to for-profit hospitals. Specifically, private nonprofit hospitals provide the highest volume of patient services, whereas public hospitals offer the lowest average price for a comparable service among all hospitals. Examination of a short-term, general acute care hospital sample from the state of California generally supports such conjecture. Managerial implications are also discussed.

Estimation of Total Body and Extracellular Water Using Single-and Multiple-Frequency Bioimpedance

1994 ◽  
Vol 28 (5) ◽  
pp. 565-569 ◽  
Author(s):  
Rakesh V. Patel ◽  
James R. Matthie ◽  
Paul O. Withers ◽  
Edward L. Peterson ◽  
Barbara J. Zarowitz
Keyword(s):  
Deuterium Oxide ◽  
Acute Care Hospital ◽  
Single Frequency ◽  
Care Hospital ◽  
Extracellular Water ◽  
Multiple Frequency ◽  
Open Label ◽  
For Profit ◽  
The Mean ◽  
Total Body

OBJECTIVE: To determine the precision and bias of single- and multiple-frequency bioimpedance estimates of total body water (TBW) and extracellular water (ECW) volumes in comparison with the true values for these volumes established by gold standard dilution techniques. DESIGN: Controlled, prospective, open-label investigation. SETTING: Private, not-for-profit university-affiliated, acute care hospital. PARTICIPANTS: Normal, healthy men (n=8) and women (n=6) volunteers, 25–46 years of age. INTERVENTIONS: A single oral dose of a mixture of deuterium oxide 10 g and bromine 30 mmol; bioimpedance analysis pre- and three hours postrnixture administration. MAIN OUTCOME PARAMETERS: TBW and ECW volumes established by deuterium oxide and bromine dilutional spaces (gold standards), respectively, and single- and multiple-frequency bioimpedance estimates of those same volumes. RESULTS: The mean multiple-frequency bioimpedance (MFB) and single frequency bioimpedance (SFB) estimates of TBW, 41.2 and 42.1 L, respectively, were not statistically different (NS) from the 41.2 L deuterium oxide value. Although the two methods had similar precision (NS), MFB was less biased. For ECW, the mean MFB and SFB values of 19.5 and 24.8 L, respectively, were significantly different from the bromine value of 18.8 L (p=0.013 and p=0.001, respectively). MFB was the more precise and less biased predictor of ECW. CONCLUSIONS: Compared with SFB, the MFB approach is a more precise and less biased predictor of TBW and ECW volumes in young, healthy adults, and may offer more accurate assessment in subjects with aberrant physiology.

scholarly journals For-Profit Hospitals Have a Unique Opportunity to Serve as Anchor Institutions in the U.S.

2020 ◽  
Author(s):  
Cory E. Cronin ◽  
Berkeley Franz ◽  
Kelly Choyke ◽  
Vanessa Rodriguez ◽  
Brian K. Gran
Keyword(s):  
Rural Communities ◽  
Public Hospitals ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Vulnerable Communities ◽  
Anchor Institutions ◽  
Current State ◽  
Reporting Mechanism ◽  
Significant Opportunity ◽  
The U.S

Abstract Background Hospitals serve as anchor institutions in many U.S. communities and make contributions to bolster population health and reduce preventable death. Most studies to date have focused on nonprofit hospitals, but there may be significant opportunity for for-profits to fill this role in both urban and rural communities. Methods We calculated descriptive statistics and a multivariate regression model to assess economic and health characteristics for all U.S. counties that contain for-profit as compared to nonprofit or public hospitals. Results For-profit hospitals are more likely to be located in counties with higher uninsurance rates and lower self-rated health. After controlling for hospital and county characteristics, we found a significant and positive relationship between for-profit hospital presence and higher county unemployment, higher uninsured rates, and the number of residents reporting poor/fair health. For-profit hospitals were also less likely to be located in states that had expanded Medicaid or which had certificate-of-need laws. Conclusions There is substantial opportunity for for-profit hospitals to serve as anchor institutions in many U.S. communities, despite this label more traditionally being applied to nonprofit hospitals. Given that there is not currently a regular reporting mechanism for documenting the community health contributions of for-profit hospitals, policymakers and researchers should evaluate the current state of these contributions and develop incentives to encourage more anchor activities to benefit economically vulnerable communities in the U.S.

Examining the relationship between hospital ownership and population health efforts

2018 ◽  
Vol 32 (8) ◽  
pp. 934-942 ◽  
Author(s):  
Meghan Hufstader Gabriel ◽  
Danielle Atkins ◽  
Xinliang Liu ◽  
Rebecca Tregerman
Keyword(s):  
Population Health ◽  
Health Management ◽  
Ownership Type ◽  
Nonprofit Hospitals ◽  
American Hospital ◽  
Population Health Management ◽  
Content Type ◽  
For Profit ◽  
Health Initiatives ◽  
The Relationship

Purpose The purpose of this paper is to investigate the relationship between ownership type and population health initiatives adopted by hospitals using the 2015 American Hospital Association data. Design/methodology/approach Hospitals of various sizes, ownership structures and geographic locations are represented in the survey. The outcome variables of interest include measures of hospital population health activities. Findings Findings indicate that nonprofit hospitals are most likely to express commitment to population health and participate in population health activities, with for-profit hospitals being least likely. Implications for policy and practice are discussed. Research limitations/implications This study demonstrates that discrepancies in population health approaches exist across ownership status – particularly, nonprofit hospitals appear to be the most likely to be involved in population health efforts. Practical implications As we continue to push for population health management in the hospital setting, grappling with the definition and purpose of population health management will be essential. Social implications Overall, these results suggest that nonprofit hospitals are more likely to be implementing population health efforts than for-profit or government-owned hospitals. Originality/value Although there are several studies on population health in hospitals, this study is the first to investigate the relationship between ownership type and population health initiatives adopted by hospitals.

scholarly journals Variation in Long-Term Acute Care Hospital Use After Intensive Care

2012 ◽  
Vol 69 (3) ◽  
pp. 339-350 ◽  
Author(s):  
Jeremy M. Kahn ◽  
Rachel M. Werner ◽  
Shannon S. Carson ◽  
Theodore J. Iwashyna
Keyword(s):  
Intensive Care ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Patient Characteristics ◽  
Hierarchical Regression ◽  
Care Hospital ◽  
Hospital Size ◽  
For Profit ◽  
Medicare Claims Data

Long-term acute care hospitals (LTACs) are an increasingly common discharge destination for patients recovering from intensive care. In this article the authors use U.S. Medicare claims data to examine regional- and hospital-level variation in LTAC utilization after intensive care to determine factors associated with their use. Using hierarchical regression models to control for patient characteristics, this study found wide variation in LTAC utilization across hospitals, even controlling for LTAC access within a region. Several hospital characteristics were independently associated with increasing LTAC utilization, including increasing hospital size, for-profit ownership, academic teaching status, and colocation of the LTAC within an acute care hospital. These findings highlight the need for research into LTAC admission criteria and the incentives driving variation in LTAC utilization across hospitals.

scholarly journals An Examination of the Mediating Role for a Nursing Information System

2017 ◽  
Vol 21 ◽  
Author(s):  
Lemai Nguyen ◽  
Nilmini Wickramasinghe
Keyword(s):  
Information System ◽  
Activity Theory ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Nursing Documentation ◽  
For Profit ◽  
Mediating Role ◽  
Not For Profit ◽  
Nursing Information System

This paper reports on findings from an examination of a nursing information system through the lens of Activity Theory. The information system was designed to support real-time nursing documentation in acute care hospital contexts. The objective was to enable superior nursing care to ensue by providing nurses with the opportunity to document patient care data into a tablet computer located at the patient bedside. The system was evaluated in a not-for-profit acute care hospital’s wards during its implementation. Nurses’ interactions with the system and their perceptions were collected and analysed through the lens of Activity Theory. The analysis highlighted nurses’ positive attitude towards the system and identified potential mediation capabilities as well as areas for improvements. Activity Theory was found to be useful to examine the positive and potentially problematic aspects of this new nursing information system.

Hospital Ownership Type and Innovation: The Case of Electronic Medical Records Adoption

2018 ◽  
Vol 47 (3) ◽  
pp. 537-561 ◽  
Author(s):  
Seth Freedman ◽  
Haizhen Lin
Keyword(s):  
Electronic Medical Records ◽  
Ownership Structure ◽  
Medical Records ◽  
Meaningful Use ◽  
Market Penetration ◽  
Ownership Type ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Percentage Points ◽  
Direct Competition

Nonprofit and for-profit firms coexist in many industries, with the hospital sector being one of the most predominant examples. This article explores whether nonprofit hospitals are more likely to make expensive investments with uncertain returns and potential public good value. Specifically, we estimate differences in the adoption of electronic medical records (EMRs) by ownership structure. We find that nonprofit hospitals are 11 to 18 percentage points more likely to have installed advanced EMR systems than for-profit hospitals by 2012. Although we find little difference in the likelihood of meeting initial government requirements for the “meaningful use” of EMRs, we find that nonprofits are 12 percentage points more likely to reach more stringent meaningful use standards that began in 2014. That being said, nonprofit adoption rates decrease as for-profit market penetration rates increase, suggesting nonprofits are less likely to adopt an uncertain technology when facing more direct competition from for-profit hospitals.

scholarly journals Patient Satisfaction With Hospital Food service and its Impact on Plate Waste in Public Hospitals in East Malaysia

2018 ◽  
Vol 3 (3) ◽  
pp. 90-97 ◽  
Author(s):  
Nur Farhana Aminuddin ◽  
Reena Kumari Vijayakumaran ◽  
Shariza Abdul Razak
Keyword(s):  
Patient Satisfaction ◽  
Quantitative Research ◽  
Food Service ◽  
Acute Care Hospital ◽  
General Information ◽  
Public Hospitals ◽  
Care Hospital ◽  
Plate Waste ◽  
Patient Satisfaction Questionnaire ◽  
Satisfaction Questionnaire

Background: Foodservice is an important issue in hospital settings, and patients’ levels of satisfaction are often indicated by consumption and plate waste. Objective: The current study compared patient satisfaction in hospital areas and other factors and determined the relationship between patient satisfaction and plate waste. Methods: This quantitative research was performed in four East Malaysian public hospitals. Patients at these hospitals were asked to complete a questionnaire which had three parts: A) general information, B) patient satisfaction questionnaire (Acute Care Hospital Foodservice Patient Satisfaction Questionnaire), and C) plate waste scale (Comstock 6-point scale). Results: A total of 189 patients participated. The results indicated that overall, 53.3%, 29.3%, 14.1%, 2.7%, and 0.5% of respondents rated the hospital foodservice as okay, good, poor, very good, and very poor, respectively. Average plate waste was 35% for all hospitals, and only 11% of patients finished all the food served. Satisfaction with hospital food differed according to the catering system (in-house and outsourced). However, the results also indicated that satisfaction with hospital foodservice was not significantly related to food wastage (r=-0.018, n=189, P=0.809). Conclusion: Various factors in hospital foodservice, especially food quality, should be improved to motivate patients to consume hospital food.

Readmission rate as an indicator of hospital performance: The case of Spain

2004 ◽  
Vol 20 (3) ◽  
pp. 385-391 ◽  
Author(s):  
Alberto Jiménez-Puente ◽  
Javier García-Alegría ◽  
Jorge Gómez-Aracena ◽  
Luis Hidalgo-Rojas ◽  
Luisa Lorenzo-Nogueiras ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Sensitivity And Specificity ◽  
Readmission Rate ◽  
Acute Care Hospital ◽  
Hospital Performance ◽  
Care Hospital ◽  
Cross Sectional ◽  
Clinical Records ◽  
Avoidable Readmissions

Objectives:Hospital readmission rate is currently used as a quality of care indicator, although its validity has not been established. Our aims were to identify the frequency and characteristics of potential avoidable readmissions and to compare the assessment of quality of care derived from readmission rate with other measure of quality (judgment of experts).Methods:Design: cross-sectional observational study; Setting: acute care hospital located in Marbella, South of Spain; Study participants: random sample of patients readmitted at the hospital within six months from discharge (n=363); Interventions: review of clinical records by a pair of observers to assess the causes of readmissions and their potential avoidability; Main measures: logistic regression analysis to identify the variables from the databases of hospital discharges which are related to avoidability of readmissions. Determination of sensitivity and specificity of different definitions of readmission rate to detect avoidable situations.Results:Nineteen percent of readmissions were considered potentially avoidable. Variables related to readmission avoidability were (i) time elapsed between index admission and readmission and (ii) difference in diagnoses of both episodes. None of the definitions of readmission rate used in this study provided adequate values of sensitivity and specificity in the identification of potentially avoidable readmissions.Conclusions:Most readmissions in our hospital were unavoidable. Thus, readmission rate might not be considered a valid indicator of quality of care.

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