Inpatient Practice

A small article about trauma in the journal JAMA last week has big implications about the business of hospital finances. In short, it shows that the U.S. spends more on trauma than any other group of diseases… and the implication is that in the future, financially healthy hospitals will need to be trauma centers. The […]

When the average person thinks of donating blood, the first words that come to mind are “Red Cross”. However, the American Red Cross only supplies about 40% of transfused blood in the United States. What most people don’t realize is that the U.S. uses a free-market approach to maintain its blood supply with the result […]

As an intern, the one specialty I was sure I did not want to go into was pulmonary. The inpatients all had either COPD or lung cancer brought on by the bad life choice of smoking, the sputum they brought up was gross, and there didn’t seem like there was anything we could do for […]

Hospitals are under enormous pressure to reduce length of stay. Since the hospital is paid by the diagnosis and not by the number of days a patient spends in the hospital, the shorter the length of stay, the higher the financial margin. In addition, if the hospital is frequently full to capacity, it is far […]

On Christmas Day, an article was published in JAMA that confirmed what many of us had suspected for a long time. When hospitals are penalized for high 30-day readmission rates, patients are more likely to die. The background is that 30-day readmission rates in U.S. hospitals are disturbingly common and very expensive. In a 2009 […]

I am on this earth because of influenza. This is the 100th year anniversary of the influenza epidemic of 1918 that infected 1/3 of the word’s population and killed 1 out of every 10 people infected. One of those people was my grandmother’s first husband. She was a nurse at a hospital in Durham, North […]

Healthcare workers are more tolerant of violence by patients than almost any other occupations would tolerate violence by customers or clients. In fact, according to OSHA, healthcare workers are more than 4 times more likely to experience workplace violence resulting in days off work than private industry. Patients are the source of workplace injuries (80%), followed […]

In September, CMS released the financial penalties that hospitals will pay for excessively high percentages of readmissions within 30 days of discharge. This is an annual event when hospitals get to find out how much their reimbursement from Medicare will be cut the next year. CMS focuses on 6 diagnoses when calculating the readmission penalty: […]

15,000 physicians responded to the annual Medscape Physician Lifestyle Survey. A component of this survey is in the Medscape National Physician Burnout & Depression Report for 2018. Of these 1,500 physicians, 42% reported being burned out. My own specialty of critical care medicine led the way with 48% reporting burnout. Women were more burned out […]

This time of the year, all across the country, hospitals are creating scorecards of quality metrics for the upcoming year. But what are the economics of those quality metric choices? It turns out each metric has very different financial implications for the hospital and so there are some metrics that are more cost-effective to achieve […]