Hospitals_08 - Hospitals PAM 435 March 27, 2008 Some Loose...

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Hospitals PAM 435 March 27, 2008
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http://www.aamc.org/programs/cim/chartingoutcomes.pdf For those who want more information about the probability of obtaining a residency match, and the characteristics of students who do obtain a match, you might consider the following report: Mean salary of plastic surgeons: $298,000 Some Loose Ends
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Source: CBS News, “Medical Tourism: Need Surgery, Will Travel,” June 18, 2004 0 20000 40000 60000 80000 Ortho surgery Partial hip replacement Full hip replacement Cardiac surgery Gall bladder surgery India U.S. Price Per Procedure: U.S. vs. India Will U.S. Elective Patients Travel to Take Advantage of Enormous Price Differences Internationally?
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Today’s Objectives 1) How the role of hospitals has changed over time. 1) How health insurers used to pay hospitals and how they pay them now. 3) The incentives created by payment methods. 1) Differences in behavior between for-profit and nonprofit hospitals.
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39% 44% 47% 41% 37% 37% 22% 22% 22% 26% 25% 25% 7% 10% 11% 11% 10% 11% 9% 6% 7% 11% 12% 4% 1960 1970 1980 1990 2000 2006 Hospitals Physician Services Source: CMS and Catlin, 2008. Other Rx Drugs Home care/ nursing home Percentage of Health Care Spending by Type of Service Hospitals Have Become Less Important Since 1980
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0 200 400 600 800 1,000 1,200 1,400 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 Inpatient Days per Thousand Source: American Hospital Association Annual Survey, 2005. …As Managed Care and Improved Medical Technology Kept People Out of Hospitals
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Physicians Hospital Grant Admitting Privileges MD refers/admits some or all of his/her patients Outpatient Services Inpatient Services Emergency Outpatient Diagnostic Surgery Labor & Intensive Med/Surg Room Surgery Testing Delivery Care Units Units Clinical Support Services - pharmacy - radiology - occupational therapy - blood bank - laboratory - physical therapy - nuclear medicine - home care Non-clinical Support Services - nursing administration - dietary - data processing - plant operations - social services - medical records - admitting dept. - purchasing Structure of a Typical Hospital
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Revenue Gross Inpatient Revenue 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 Percentage of Revenue Source: American Hospital Association Annual Survey, 2005. Hospitals Have Adapted: Outpatient Care Now
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Hospitals_08 - Hospitals PAM 435 March 27, 2008 Some Loose...

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