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:10/13/2017)... , ... October 13, 2017 , ... “The Journey: From ... every danger possible to save lost souls in the Philippines. “The Journey: From the ... is a dedicated teacher of the Bible. She has taught all ages and currently ...
(Date:10/12/2017)... ... October 12, 2017 , ... First ... compliance program management, will showcase a range of technology and learning solutions at ... (NCAL) Convention and Expo to be held October 14–18, 2017 at the Mandalay ...
(Date:10/12/2017)... Orleans, LA (PRWEB) , ... October 12, 2017 , ... ... centers in the U.S., announced today its plans to open a flagship location in ... will occupy the former Rooms To Go store next to Office Depot in the ...
(Date:10/12/2017)... ... October 12, 2017 , ... IsoComforter, Inc. ( https://isocomforter.com ), ... of an innovative new design of the shoulder pad. The shoulder pad provides ... while controlling your pain while using cold therapy. By utilizing ice and water that ...
(Date:10/12/2017)... ... October 12, 2017 , ... Asante, ... post-acute health care, have expanded their existing home health joint venture through an ... has been operating a joint venture home health company with Asante, delivering clinically ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... Oct. 2, 2017  AllianceRx Walgreens Prime, the combined ... Walgreens and pharmacy benefit manager Prime Therapeutics LLC (Prime), ... which included the unveiling of new signage at its ... well as at a few other company-owned facilities across ... to patients, some of whom will begin to see ...
(Date:10/2/2017)... Denmark , Oct. 2, 2017 The Rebound ... in the struggle to reverse the tide of prescription drug ... for regulating their medicine intake and stepping down their dosage ... set to launch in December 2017; the first 100,000 people ... Learn more at http://www.rebound-solution.com/ ...
(Date:9/28/2017)... 2017 Cohen Veterans Bioscience and Early Signal ... wearable and home sensors for real-time monitoring of patients ... a nonprofit organization focused on disruptive health solutions for ... analytical system to record and integrate behavioral, cognitive, physiological ... ...
Breaking Medicine Technology: