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In the News
From the October ACP Hospitalist, copyright © 2008 by the American College of Physicians
Report shows slowdown in hospital cost increases
U.S. hospitals have made significant progress in stemming the rise of patient care costs, according to a recent Agency for Healthcare Research and Quality (AHRQ) report.
The cost of patient care in U.S. hospitals rose by just under 1% between 2005 and 2006, down from an average increase of 5.3% per year between 1997 and 2005. Despite this improvement, the overall cost for hospital stays nearly doubled from $177 billion to $329 billion from 1997 to 2006, an average annual increase of 7.1%. The findings suggest that the pervasiveness of managed care and the increased reliance on outpatient services have slowed the growth of inpatient care.
Greater use of services was responsible for almost half (47%) of the rise in patient care costs over the nine-year period, the report said. Baby boomers aged 45 to 64 represented the largest increase in hospitalizations per patient with an increase of 40% from 1997 to 2006, followed by adults age 85 and older (26% increase).
The three most costly conditions treated in U.S. hospitals in 2006 were coronary artery disease, heart attack and congestive heart failure. The most frequent principal diagnoses were pregnancy/ childbirth, pneumonia and coronary artery disease. The report also noted that the average length of stay in U.S. community hospitals stabilized beginning in 2000 at 4.6 days—almost 20% shorter than in 1993, when it was 5.7 days.
Also, between 1997 and 2006, the AHRQ analysis found:
- Discharges with a respiratory intubation and mechanical ventilation procedure grew by 41%;
- Discharges to home health grew by 53%;
- Discharges to nursing homes grew by 30%; and
- In-hospital deaths decreased by 5%.
The study data came from the 2006 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. The report includes information from a database of discharge records for all patients treated in a sample of about 1,000 non-federal, short term, acute care community hospitals.
Online resource helps with avoiding drug errors
A new online resource enables physicians and consumers to look up drug names that have been identified with a medication error. The USP Drug Error Finder, from the nonprofit U.S. Pharmacopeia, is based on the group’s annual report on medication errors involving drug nomenclature. It is online.
The free Web tool includes more than 1,400 drugs that have been involved in look-alike and/or sound-alike errors. It lists the drugs involved in the mix-up, as well as the error severity.
AHRQ offers tool to evaluate disaster response
The Agency for Healthcare Research and Quality (AHRQ) is offering hospitals a tool to assess their disaster response programs so they can participate in the Department of Health and Human Services’ Hospital Preparedness Program.
The Tool for Evaluating Core Elements of Hospital Disaster Drills can help hospitals meet requirements to provide executive summaries of disaster drills conducted at their facilities. Its evidence-based modules use checklists to note events that occur during drills, concentrating on functional zones such as the command center, decontamination, triage and treatment. The tool is an abridged version of a more detailed evidence report from AHRQ’s Johns Hopkins University Evidence-Based Practice Center in Baltimore, and also includes pre-drill and debriefing modules.
Single copies can be ordered at no cost by e-mailing ahrqpubs@ahrq.hhs.gov or calling 800-358-9295. The tool can also be accessed online.
Survey finds chronic illness common among uninsured
An estimated 11.4 million Americans with chronic medical conditions, such as cardiovascular disease, hypertension and diabetes, are uninsured, according to a data analysis from the National Health and Nutrition Examination Survey.
The survey, which occurred between 1999 and 2004 and involved more than 12,000 patients aged 18 to 64, found that chronically ill patients without insurance were less likely than insured patients to report a physician visit within the last 12 months.
Chronically ill patients were also more likely to report using an emergency department as a standard site for care. The analysis was published in the August 5, 2008 Annals of Internal Medicine.
The authors estimated that nearly one-third of uninsured U.S. adults had at least one chronic condition. However, the authors said that given the limited access to care among those without insurance, undiagnosed conditions in this population may be common. They called for advocacy focused on expansion of health insurance coverage, as lack of health insurance is strongly associated with poor access to care.
In the News is a product of ACP HospitalistWeekly, an enewsletter provided every Wednesday by ACP Hospitalist. If you’re not already receiving ACP HospitalistWeekly, contact Customer Service at 800-523-1546, ext. 2600, or directly at 215-351-2600 (M-F, 9 a.m. to 5 p.m. EST) or send an email to custserv@acponline.org.
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