Navigation Links
Quality Lags at Safety-Net Hospitals
Date:5/13/2008

Lack of money prevents hospitals that treat the poor from improving, study finds

TUESDAY, May 13 (HealthDay News) -- The quality of care at hospitals that treat poor and underserved patients, often called safety-net hospitals, is lagging well behind hospitals that do not serve these patients, a new study finds.

These hospitals, which rely on state and federal funding from Medicaid and other sources, do not have the money to improve the quality of care at the same rate that better-funded hospitals do.

"Safety-net hospitals provide a lower quality of care than non-safety-net hospitals," said lead researcher Dr. Rachel M. Werner, from the Philadelphia VA Medical Center. "Over time, the quality was lower than non-safety-net hospitals."

This is important, because hospital performance determines the funding that many hospitals get under pay-for-performance policies, Werner said. "Hospitals that are doing worse are going to get penalized," she said.

Safety-net hospitals tend to be inner-city and teaching hospitals, Werner noted.

"Finances at safety-net hospitals are often worse than at non-safety-net hospitals," Werner said. "This is because they provide more care to uninsured patients and more care for Medicaid patients. With less money, they have less to put into quality improvement."

Under pay-for-performance, a system that rewards quality care, safety-net hospitals fare worse, Werner added. "You get into a situation where rich hospitals get richer, but the poor hospitals become poorer," she said.

Her report is published in the May 14 issue of the Journal of the American Medical Association.

In the study, Werner's team used data collected between 2004 and 2006 from 3,665 safety-net and non-safety-net hospitals.

The researchers found that hospitals that cater to a low percentage of Medicaid patients had significantly more improvement in quality compared with safety-net hospitals.

For example, hospitals that have a low number of Medicaid patients improved the care of heart attack patients by 3.8 percentage points compared with safety-net hospitals, whose performance improved 2.3 percentage points.

This means that there was a 39 percent difference between safety-net and non-safety-net hospitals in caring for heart attack patients. The same pattern was repeated in the other conditions looked at, which included heart failure and pneumonia.

Moreover, hospitals, with a high percentage of Medicaid patients were less likely to be ranked by the U.S. Centers for Medicare and Medicaid Services as top performers. In fact, hospitals with a high percentage of Medicaid patients saw their quality ratings drop from 10.1 percent in 2004 to 2.8 percent in 2006, the researchers found.

At the same time, hospitals that treat a low percentage of Medicaid patients saw their quality ratings increase from 13.6 percent to 19.7 percent across all three medical conditions measured.

Werner thinks the solution to these problems is to provide safety-net hospitals with government funding specifically targeted to improving the quality of care. "The financial incentives should be restructured to reward improvement efforts, rather than achievement, safety-net hospitals could benefit," she said.

If the situation doesn't improve, the disparity between hospitals will only worsen, Werner said.

"This is concerning, because there are people who rely on these hospitals for their care, and ultimately you end up penalizing those patients by allowing this disparity to widen," Werner said. "It's possible that some of these hospitals will be forced to close. And this is a concern, because they provide an avenue of health care for many people who can't go elsewhere."

One expert also thinks the government needs to take the lead in improving the quality of care in safety-net hospitals.

"To improve care, you have to have resources," said Dr. Donald M. Berwick, a professor of pediatrics and health policy and management at Harvard Medical School, and president and CEO of the Institute for HealthCare Improvement. "This study confirms that very stressed organizations, that are living hand-to-mouth, are going to have trouble making improvements."

Berwick thinks it's going to take a large investment of government monies to improve quality at these hospitals.

"We ought to, as a nation, regard improvement of health care as a public good," Berwick said. "It's not just a matter of market pressures, but it's something we invest in as a society. We are a nation that needs public sector health care. We need health care to be just, and that means we need safety-net systems, and that means we need to help them."

More information

For more on Medicaid, visit the U.S. Centers for Medicare and Medicaid Services.



SOURCES: Rachel M. Werner, M.D., Ph.D., Philadelphia VA Medical Center; Donald M. Berwick, M.D., professor, pediatrics and health policy and management, Harvard Medical School, and president and CEO, Institute for HealthCare Improvement, Boston; May 14, 2008, Journal of the American Medical Association


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. More proof needed of safety and quality of electronic personal health records
2. Pitt study finds inequality in tobacco advertising
3. Poor indoor air quality means poorer health for patients with COPD
4. Kingfisher Healthcare (KFH) Achieves World Class Quality Platform
5. Exempla Healthcare Contracts For Talismans Quality Donor System
6. Study finds primary care depression treatment often does not follow quality guidelines
7. Income inequality associated with overnourishment and undernourishment in India
8. Exercise and yoga improves quality of life in women with early-stage breast cancer
9. Patient Advocate Foundation Launches Program to Help Uninsured Virginians with Chronic, Debilitating and Life-Threatening Illness Access Quality Healthcare
10. Bridgetech Announces Addition of the Agency for Healthcare Research and Quality as Content Provider in its Development of a Healthcare Web Portal in China
11. 7th Annual Quality Conference: 2 Days to Lock in Discounted Rate at The Ritz-Carlton
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Quality Lags at Safety-Net Hospitals
(Date:4/30/2016)... ... April 30, 2016 , ... Dr. Trevor Gardner, President of ... signed a multifaceted agreement which will allow for the research and development of ... Natural and Applied Sciences, Allied Health and Nursing will work together to develop ...
(Date:4/30/2016)... Santa Rosa, CA (PRWEB) , ... April 30, 2016 , ... “Aging well is a challenge for all of us, ... says NCMA’s Dr. Parul T. Kohli . “Research is showing more and more that ... the risk of disease and disability as we age.” Top priorities Dr. Kohli’s recommends for her ...
(Date:4/29/2016)... ... April 30, 2016 , ... World ... the Pick Up Springboard, an automotive invention that improves the storage features of ... worth $162 billion," says Scott Cooper, CEO and Creative Director of World Patent ...
(Date:4/29/2016)... ... April 29, 2016 , ... In an article published ... her enthusiasm for Botox and lip injections, which she underwent in order to feel ... Valley Music and Arts Festival. The article explains that Ms. Mirmelli’s situation is not ...
(Date:4/29/2016)... Fl (PRWEB) , ... April 29, 2016 , ... ... recently notified by the Accreditation Council for Graduate Medical Education (ACGME) that it ... , This is the first accreditation of three residency programs that Memorial is ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... , April 28, 2016   Click here ... Pharmacy, Inc. (NYSE: DPLO), the nation,s largest independent ... a definitive agreement to acquire Valley Campus Pharmacy, ... ("TNH"), a leading specialty pharmacy that provides individualized ... California . In 2015, TNH generated approximately ...
(Date:4/28/2016)...  Marking its one year anniversary since launching ... risk test, Color Genomics announced a ... impact the most common hereditary cancers affecting both ... analyzes hereditary cancer risks for breast, colorectal, melanoma, ... Color Test is physician ordered and includes genetic ...
(Date:4/28/2016)... , April 28, 2016 ... consumer insights on healthcare, announced today that it has ... report Cool Vendor in Life Sciences, 2016, ... 15, 2016.  The report focuses on life-science- oriented analytics, ... insight from patients and doctors, confirm medication ingestion, and ...
Breaking Medicine Technology: