Unwarranted opposition to hospital consolidation will be a disservice to our patients and to our nation. Here's why.

Abstract The US Navy hospital ship USNS Comfort played an integral role in the initial phases of Operation Unified Response-Haiti following the devastating earthquake that struck near Port-Au-Prince, Haiti, on January 12, 2010. Deployed to Haiti from its home in Baltimore, Maryland, just 4 days after the earthquake, the USNS Comfort ...

While a federal judge in Florida ignited the latest skirmish over the healthcare law by ruling it unconstitutional, hospitals are still pushing ahead with implementation. "If the law stands, the implementation dates will stand," says Richard Morrison, right, of Adventist Health System's Florida Division. "If you're planning for it to ...

Little is known about the ability of incentives to influence decisions by physicians regarding choices of settings for care delivery. In the context of outpatient procedural care, the emergence of freestanding ambulatory surgery centers (ASCs) as alternatives to hospital-based outpatient departments (HOPDs) creates a unique opportunity to study this question. ...

In the 1980s and 1990s, physician capitation-in which participating physicians received a fixed sum for each insured patient regardless of how much care the patient received-was widely touted as a way to restrain costs and encourage more-efficient care. Capitation remained prevalent in markets with a substantial health maintenance organization (HMO) ...

About 30% of doctors working in inpatient and outpatient departments suffer from burnout, characterized, for example, by emotional exhaustion. The prevention of burnout constitutes a great challenge for those responsible for the healthcare system. Research into the relationship between social capital in hospitals and the occurrence of emotional exhaustion in ...

The delivery of health care is a capital-intensive industry, and thus, hospital investment strategy continues to be an important area of interest for both health policy and research. Much attention has been given to hospitals' capital investment policies with relatively little attention to investments in financial assets, which serve an ...

The goal the team behind Birmingham Children's Hospital's new pound 2.7 million Children's Kidney Unit set itself was to create a comfortable and relaxing, but equally lively, colourful, and stimulating environment that would help "transform, into something more bearable, and even fun" the time spent in hospital by young patients ...

PURPOSE OF REVIEW: The funding landscape for medical devices is becoming increasingly difficult and complex. The purpose of this article is to provide the physician entrepreneur with a review of the main sources of capital available to fund the development and commercialization of biomedical innovations, and to highlight some of ...

Recent economic challenges have left many independent hospitals and their boards concerned about long-term viability of their organizations as stand-alone facilities. The CFO's role should be to facilitate a candid, objective assessment of the organization's ability to continue to go it alone. Key indicators that should be considered in such ...

Benefits from selling noncore assets include generating capital and freeing up management resources. Monetization transaction structures include sale, partnership, and strategic affiliation. A hospital that engages in such a transaction needs to ensure that the purchaser or joint venture partner will maintain the hospital's high standards of care and ethical ...

Capital equipment strategic planning (CESP) is a data-driven method that can be used for evaluating a hospital's existing equipment in light of its business goals and budget to develop an unbiased multiyear plan for replacing aging equipment. The foundation for CESP is a rigorous technology assessment of all clinical equipment ...

BACKGROUND: Effective preparedness for pandemic influenza necessitates acquisition and maintenance of vital equipment and infrastructure. The aim of this study was to investigate the relationship between the level of hospital preparedness relating to infrastructure and equipment and performance of the hospital in an avian flu drill. METHODS: The levels of ...

A recent study of changes in U.S. hospitals' capital spending and financing disclosed that between 2001 and 2007: Annual capital spending rose from $25.1 billion to $34.7 billion. Hospitals shifted capital spending toward physical infrastructure and away from equipment. Not-for-profit hospitals spent a significantly lower percentage of available funds on ...

Salt, vinegar and wine sounds more like a recipe from the Saturday kitchen, but in 1667 it was all a surgeon could use to close wounds, along with silk and linen strips. In providing this service, barbers and surgeons found themselves confused and intertwined, struggling for professional recognition that was ...

The results of this year's Most Wired survey shows an uncomfortable collision between the need to conserve capital and to invest in information technology.

Obesity is a global epidemic, responsible for 2000 premature deaths in Ireland each year. The extent of this epidemic was quantified by the National Taskforce on Obesity (IOTF), whose report, published in 2005, found that 39% of adults in Ireland were overweight and 18% obese with obesity in adults predicted ...

Hospitals should focus on optimizing performance in five primary areas of capital investment: facilities, IT, physician networks, service lines, and clinical equipment/technology. Hospitals require a broad evaluation framework to help identify the key issues and concerns associated with each area. Discipline is critical to this process, so that every area ...

CFOs at hospitals throughout the country are implementing strategic initiatives that can help their organizations succeed in challenging times: Revising strategic plans, Reassessing capital capacity, Leveraging IT to enhance revenue management.

'Cream skimming' refers to choosing patients for some characteristic(s) other than their need for care, which enhances the profitability or reputation of the provider. Under capitation or other fixed payment schemes, this often means choosing less ill patients. We present a new methodology to measure cream skimming by hospitals. Our ...

BACKGROUND: Job satisfaction in the hospital is an important predictor for many significant management ratios. Acceptance in professional life or high workload are known as important predictors for job satisfaction. The influence of social capital in hospitals on job satisfaction within the health care system, however, remains to be determined. ...

OBJECTIVE: Within days of each other, 2 catastrophic fires occurred in Kenya. On January 28, 2009, a busy supermarket was destroyed in downtown Nairobi. Shortly thereafter on February 2, an overturned petrol tanker exploded near the village of Molo, 200 km from the capital. These 2 disasters, in an urban ...

Today's lending dynamics are leading many hospitals to revisit their strategies for accessing capital: Fixed-rate bonds will likely be a centerpiece of just about any organization's capital structure going forward. Joint partnerships with physicians may provide opportunity for specific service-line strength without heavy investment in facility and equipment. Many hospitals ...

Amid the current economic turmoil, some of the casualties are hospital building projects. More than half of the respondents to a survey by the American Hospital Association said they were reconsidering or postponing capital projects. "Arizona hospitals are hurting as bad as I've ever seen them," says John Rivers, left. ...

Objective. To examine the relationship between social capital and preventable hospitalizations (PHs). Data Sources. Administrative and secondary data for Florida (hospital discharge, U.S. Census, voting, nonprofits, faith-based congregations, uninsured, safety net and primary care providers, and hospital beds). Study Design. Cross-sectional, zip code-level multivariate analyses to examine the associations among ...

President Bush's fiscal 2009 budget proposal comes equipped with $200 billion in Medicare and Medicaid savings. While the Bush administration deems the figure necessary to ensure the programs remain solvent, hospitals are crying foul. Michael Connelly, left, president and CEO of Catholic Healthcare Partners, said Bush's budget proposal "fundamentally missed ...

Capital investments in the latest medical equipment and the replacement of aging facilities are critical decisions for sustaining hospitals' financial viability. A recent survey over the period 1997 to 2001 found that hospitals increased their capital expenditures by only 1%. The aim of this study is to gain insight into ...

The physician workforce shortage and inequity of physician distribution throughout Oregon require the Oregon Health & Science University (OHSU) School of Medicine to graduate more physicians and increase the number committed to practice in nonurban areas. The most cost-effective and expedient method to accomplish these goals has been to develop ...

OBJECTIVE: To investigate the accuracy of assessment of burn surface area and depth using a basic camera-equipped mobile phone. METHODS: 31 patients with minor burns were assessed at the Welsh Centre for Burns & Plastic Surgery. RESULTS: A high correlation was found between assessment of burn surface area and burn ...

When seeking debt financing, a hospital should monitor elements affecting its credit profile and ability to access capital throughout the financing. Hospitals should monitor backup borrowing options. Internal and external factors affect the perception of a hospital as a borrower, and midfinancing changes to either can open and close doors ...

Hospitals routinely enter into contracts with radiology groups for the right to be the exclusive providers of radiologic services at the facilities in exchange for the groups' agreeing to provide and manage all aspects of those services within the hospitals. These exclusive contracts generally result in radiology departments and associated ...

To provide better emergency and outpatient services in well-equipped field hospitals, organisation and team and equipment selection are of utmost importance to meet the demands of the earthquake zone. In the planning stage, the evaluation of data collected after the earthquake is essential. On 14 October 2005, following the earthquake ...

Hospital construction projects take place over several years, from the initial decision to build to their completion and start of service. The owner and his building and civil engineering department have to face many administrative processes and complex techniques. It is the role of the clinical engineer to furnish the ...

In contrast to capital leases, which are reported on the balance sheet as debt, operating leases are a form of off-balance sheet financing only reported in the notes to the financial statement and have limited disclosure requirements. Following the perpetuity method of corporate finance, this study developed a capitalized operating ...

This paper presents results of a Capital Equipment Management Plan undertaken at a major acute hospital in Australia. By classifying existing equipment using a threshold replacement value into Major and Minor items, detailed planning information was collected for 527 items of Major equipment representing 80% of the hospital's total equipment ...

We report the development and implementation of an electronic inpatient physician documentation system using off-the-shelf components, rapidly and at low cost. Within 9 months of deployment, over half of physician notes were electronic, and within 20 months, paper physician notes were eliminated. Our results suggest institutions can prioritize conversion to ...

The diffusion of wireless technology has caused concerns about interference in the hospital environment. Most hospitals have banned the use of cell phones on their premises although wireless technology can help in delivering time critical help to patients. We discuss some factors of radio frequency (RF) near field interference. These ...

OBJECTIVES: The purpose of this study was to examine the diffusion patterns of new medical technologies in Korean hospitals. We also sought to identify critical factors leading to the decision to acquire capital-intensive medical technology. The rationale and timing of magnetic resonance imaging (MRI) acquisitions were retrospectively evaluated according to ...

Psoriasis is a chronic skin disorder which is believed to affect 2% of the world's population. This retrospective study analyzed the frequency of occurrence of psoriasis in the population of a dermatology clinic in a general hospital in the capital city of Trinidad and Tobago. Psoriasis was found to be ...

It is generally realised that mobile phones can interfere with medical electrical equipment and many hospitals have policies which aim to minimise the risk to their patients from this cause. Walkie talkies are also used in hospitals, but very little information is available concerning their ability to interfere with hospital ...

Vitrification can be used successfully to cryopreserve equine embryos. Embryos for vitrification should be collected from donor mares' uteri when they are 300 mm or less in diameter, however,and at the morula or early blastocyst stage of development. No special equipment is required for vitrification; the straw containing the embryo ...

Tax-exempt capital leases, when structured through the appropriate conduit authority, are an excellent option for financing equipment that the hospital wants to own. Operating leases offer the benefits of immediate cash flow savings when compared with buying equipment, fewer complications and lower upfront costs when compared with bond issues, and ...

OBJECTIVE: The objective of this study was to develop and evaluate a method of allocating funding for very-high-cost (VHC) patients among hospitals. RESEARCH DESIGN: Diagnostic cost groups (DCGs) were used for risk adjustment. The patient population consisted of 253,013 veterans who used Department of Veterans Affairs (VA) medical care services ...

The purpose of this study was to determine the effectiveness of pneumatic reduction of intussusception using equipment readily available in the hospital. Twenty-two children aged between four months and four years had pneumatic reduction of intussusception. The device used was assembled using (i) a hand-held pump attached to a pressure ...

Feline physeal dysplasia typically presents as unilateral or bilateral, atraumatic, slipped capital femoral epiphysis. The femoral physeal lesion consists of retention of a cartilaginous physis beyond the expected age of closure, with disorganization of the chondrocytes and subsequent slippage. In this article, we describe two cats with feline physeal dysplasia ...

Hospitals and health systems, whether general acute care hospitals or specialty-driven hospitals, are attempting to prosper in a unique time. This year, hospitals throughout the country will see increased reimbursement for hospital inpatient services, rather than decreased reimbursement. Many hospitals are examining a multitude of options for debt financing and ...

Hospital technology decision makers now confront a growing pipeline of information technology (IT) and major medical equipment that challenges traditional capital allocation processes. In a highly fragmented industry that is driven by coverage and reimbursement policies set by the Centers for Medicare and Medicaid Services (CMS) and private insurers, the ...

This paper examines the impact of the defendant's appearance during the trial on capital jurors' punishment decision. The data used in this analysis were gathered by the Capital Jury Project (CJP), a national program of research on the decision-making of capital jurors. A series of multivariate logistic regression analyses were ...

The current fascination with electronic medical records (EMRs) is not new. For decades, vendors have capitalized on this enthusiasm. But hospitals and clinics have ended up with little to show for their large outlays. Indeed, computing at a typical hospital has not gotten much beyond what was available twenty-five years ...

BACKGROUND: There are wide variations in survival after cardiopulmonary resuscitation. The aim of this survey was to describe how equipment provision of resuscitation trolleys was deployed in a range of clinical ward areas. METHODS: The equipment in randomly selected resuscitation trolleys in all 14 South West Thames Region hospitals was ...