Navigation Links
Revenue-driven surgery drives patients home too early
Date:5/11/2012

COLLEGE PARK, Md. - Revenue-driven surgery and poor planning drive some surgical patients home too early, concludes a pair of logistical studies conducted by researchers at the University of Maryland's Robert H. Smith School of Business.

The studies show a correlation between readmission rates and how full the hospital was at the time of discharge, suggesting that patients went home before they were healthy enough.

The researchers recommend better planning and other logistical solutions to avoid these problems.

The studies appear in the two most recent issues of the peer-reviewed journal Health Care Management Science:

*"The impact of hospital utilization on patient readmission rate" http://ter.ps/sj

*"Examining the discharge practices of surgeons at a large medical center" http://ter.ps/sk

"Discharge decisions are made with bed-capacity constraints in mind," says University of Maryland Professor Bruce Golden, the Smith School's France-Merrick Chair in Management Science, who conducted the research with Ph.D. student David Anderson and other colleagues.

"Patient traffic jams present hospitals and medical teams with major, practical concerns, but they can find better answers than sending the patient home at the earliest possible moment," Golden adds.

In the studies, Golden and Anderson tracked patient movement at a large, academic medical center located in the United States.

They found that patients discharged when the hospital was busiest were 50 percent more likely to return for treatment within three days. This indicates recovery was incomplete when patients were first released, the researchers say. The study tracks occupancy rates, day of the week, staffing levels and surgical volume.

Surgeons and hospitals are incentive-driven to perform as many surgical procedures as feasible, Golden says.

"The hospital has to maintain revenue levels to meet its financial obligations. Surgeons are working to save lives and earn a livelihood. It's what they do," he explains. "If the hospital says 'sorry there are no beds available,' there's a lot of tension and pressure from both sides to keep things moving."

These problems are much more likely at large hospitals, which tend to provide more advanced, specialized surgeries not accessible at smaller, community institutions,the researchers say. Patients often have to travel a great distance for the procedures, so hospital delays become expensive for both them and the care providers.

The study findings cover surgical discharge data from fiscal year 2007 covering more than 7,800 surgery patients who collectively spent 35,500 nights at the facility.

"This gives us a good snapshot of the pressures at work in a busy non-profit hospital," Golden adds. "Other institutions may handle the challenges somewhat differently, but the pressures are widespread and these results call for some introspection."

BETTER LOGISTICS

"Too often, the biggest problem is that hospitals just don't plan ahead, and this is what gets them in trouble" Golden says. "There are logistical alternatives to sending a patient home too soon."

He suggests that surgeons use checklists before discharging the patient. "They know better than we do what questions should be asked - questions that would force the surgeon to think about whether they were discharging the patient for the right reason."

Recently, for example this checklist approach has been used successfully to reduce hospital bacterial infections, Golden points out.

Also, he suggests that hospitals increase the flexibility of where patients go post-surgery. Allowing them to be moved to units with empty beds, for example, could also lessen premature discharges.

Though, this may increase costs in the short run, discharging patients who then quickly return to the hospital offers no long-term savings, and decreases the quality of care, Golden adds.


'/>"/>
Contact: Neil Tickner
ntickner@umd.edu
301-405-4622
University of Maryland
Source:Eurekalert  

Related medicine news :

1. Less-Invasive Surgery for Esophageal Cancer Might Be Safer
2. New Techniques May Improve Infant Heart Surgery
3. Brain surgery for epilepsy underutilized
4. Lower Risk for Bowel Obstruction With Less Invasive Surgery: Study
5. Men More Prone to Complications After Brain, Spine Surgery
6. Brain Surgery Might Ease Tough-to-Treat OCD
7. Weight-Loss Surgery Beat Drugs for Cutting Diabetes in Very Obese
8. Study examines medicare use for Mohs micrographic surgery and surgical excision for skin cancer
9. Surgery Rates Rising for Non-Melanoma Skin Cancer: Study
10. Codeine After Surgery Could Endanger Certain Kids: Study
11. Optimal care of bariatric surgery patients vital for long-term health and well-being
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Revenue-driven surgery drives patients home too early
(Date:2/12/2016)... Opelousas, LA (PRWEB) , ... February 12, 2016 , ... ... of St. Landry and Evangeline Parishes. The purpose of these scholarships is to ... to encourage those individuals to seek employment within these two parishes. , “We ...
(Date:2/12/2016)... ... ... Enforcement Trends: , Back to the Future , Feb. 25, 2016 — 11:00 a.m. – ... who don’t learn from history are doomed to repeat it.” , An analysis of CDRH’s ... But that takes time. , Take a close look at the warning letters the ...
(Date:2/12/2016)... (PRWEB) , ... February 12, 2016 , ... As a ... hectic schedule, a demanding job, and no time to decompress, Rabinowitz found herself drawn ... herself to meditation for its impact on her life, implementing a 20-minute-per-day meditation practice ...
(Date:2/12/2016)... ... February 12, 2016 , ... ... Series at Zuckerberg San Francisco General Hospital on April 5-7. The series is ... and create new habits. The workshops cover a broad range of topics, including ...
(Date:2/12/2016)... Vegas, NV (PRWEB) , ... February 12, 2016 , ... ... North Las Vegas Mayor John J. Lee, Nevada Military Support Alliance president Scott Bensing, ... Fisher House at the VA Southern Nevada Healthcare System. This will be the ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... --  National Community Pharmacists Association (NCPA) CEO ... statement today in response to the detailed "preferred pharmacy" ... Medicare & Medicaid Services (CMS) and conducted in response ... patient advocacy organizations and members of ... CMS analysis. Our initial reaction is that more work ...
(Date:2/12/2016)... 2016 /PRNewswire/ - Demers Ambulances announces its first delivery in the ... Okaloosa County Emergency Medical Services (EMS) consisting of ... LT2 van. Quality Emergency Vehicles in Lecanto, FL ... sale.  This is the latest in Demers, ongoing expansion of ... at Demers. --> Benoit LaFortune , Executive Vice ...
(Date:2/12/2016)... -- Memorial Hermann Health System has teamed up with Houston ... a one-of-a-kind experience to pediatric patients at Children,s ... 360-degree video and Google Cardboard, Howard was able to ... the patients and their families an unexpected, and energetically ... video . Memorial Hermann IRONMAN Sports ...
Breaking Medicine Technology: