In an Austin American Statesman article written by Mary Ann Roser on Saturday, March 24, 2012, government payments to hospitals will soon be linked to care that they provide and to patient satisfaction scores. As consumers, we should have the right to have access to more information regarding hospitals in our area. Government should require hospitals to report more information on complications and should require more information to be available to the public. As prospective patients, we have a choice in the hospital we choose. We should know the truth about all of our potential choices and have valid information about each hospital in our area.
Although a below average score on the reports is not ideal, a public hospital such as University Medical Center Brackenridge deals with many more obstacles than a private hospital. Those who have the choice not to go there CAN go to other nearby hospitals, but many patients arrive in a hospital who were involved in a serious accident and did not plan on coming to a hospital. In these cases many are transported to specific locations such as the Trauma Center at Brackenridge. These ratings are important to show specialization for each hospital in the area. Some patients require specialized treatment, which can only be received at specific hospitals in our surrounding area. These issues are real and can affect anyone at any time. Having the appropriate data available helps everyone make an educated decision on their health care choices and everyone deserves to know the truth. “Americans know more about the car they drive than the hospitals where they entrust their and their loved ones’ lives.”
The idea is for Medicare to reward hospitals based on the quality of care they provide and will begin in October of this year. Poor health care is costly and there should be more interest in patient safety. Reports on deaths, complications, and infection should be mandatory for hospitals. Also, more information about doctors/surgeons should be required. With surgery being one of the leading causes of infection, I agree that "Patient's doctors are the best consumer guides". In conjunction with enforcing stricter guidelines on hospital reports, the government should make the data more easily accessible. These scores are important determining factors for where we will choose to go if and when the necessary time comes and it is surprising to see that legislature did not fund the requirement of reporting infection rates until 2009.
Thousands of dollars are being paid out by Medicare for hospital stays that could have been prevented. Improving these areas could save a lot of money for both insurance companies and patients. It is incredibly important that more people know about these issues and make a stronger effort to make a change. Especially hospital staff. Guidelines can be set, but must be followed to ensure further complications. Infection spreads fast once inside a hospital setting. It is up to all hospital staff to abide by the training they have received in order to keep the infections from spreading to themselves and others.
Over all, I agree with the legislature to begin enforcing stricter laws on hospital reports. Medicare is on the right track and in Texas we hope to see more Insurance companies following soon. Because after all, hospitals are businesses too, and like the article states, “Once you start tying dollars to it, you’re going to see hospitals pay more attention to it.”
Comment: Part 1 of 2
ReplyDeleteIn a classmate's assignment titled, "Curious Consumers Start to See More Hospital Data," she writes about the new proposed law linking government payments to hospitals in conjunction with patient satisfaction scores. Under this new proposal, the Center for Medicare and Medicaid (CMS) will begin to withhold reimbursement payments to hospitals based on unfavorable scores patients give regarding their hospital stay. I found this article to be interesting because I work in the health field and I see the results of these new measures already taking effect. While I do agree with one of the points she made, I disagree with others.
I have worked in the health care industry for about 9 years both in a publicly funded and privately run hospital with constant patient interaction. If you have never worked in a hospital setting where you are directly responsible for taking care of people, it's hard to explain or imagine what a care provider has to go through each day. It's one thing to hear about it coming from a family member who is a nurse or a doctor than it is to actually experience it day by day.
Under the new proposal, 1 percent of the reimbursed payments made by the CMS, about 850 million in the first year, will go into a pool to be doled out as bonuses to hospitals that receive an above average score that is based on several measures. Who do you think that money is going to go to? Most likely, hospitals that can afford luxury amenities and whose level of care is different compared to a public hospital like University Medical Center at Brackenridge (UMCB) here in Austin. The author states that UMCB has more obstacles than a private hospital which would probably lower their score. And she would be right. Private hospitals which generate money can afford to look like a hotel and treat their patients like guests to make their stay more comfortable. A public hospital like UMCB doesn't generate the same funds as a private hospital does because they are mostly responsible for taking care of the uninsured which include the homeless and undocumented. Any number of reasons could be used to score a hospital low. For example, telling a patient "no" can anger them even though it might be for their own good. Nurse to patient ratio is not established in Texas which means a nurse could get up to 6 or 8 patients, all of them needing him/her at once. It's a no win situation when one patient is left behind for another. Do they have to show preference for a more vocal patient so that the hospital can receive a higher score instead of those who are in need of greater care? It's a Catch 22.
Comment: Part 2 of 2
ReplyDeleteA point that my classmate makes is a point that I can agree with, but with some reservations. She states that the government should make critical information regarding a hospital's history of complications more available to the public. Reports on deaths, infections and complications would be informative and would enable the public to make a more informed choice as to which hospital they chose to go to. I agree, but I think it should be done more accurately. For example, if a major trauma or complicated infection was transferred from one hospital to another and the end resulted in a death, the original hospital should be the one held responsible. As of now, it falls on the shoulders of the receiving hospital, which in turn would lower their score. In another example, a patient is discharged with specific instructions but has to be readmitted because they failed to comply with the orders given (which happens a lot). That needs to be taken into consideration as well and not be held against the hospital. At other times, a patient's health improves and they are transferred to another facility to continue their care. Unfortunately, sometimes the proper care is not administered and they end up having to be sent back. Situations like that would be held against the hospital. I do not believe that grading the hospital in that manner is fair.
The author also states that hospital staff need to follow guidelines to avoid further infections and complications. Believe me, we do! Now, try telling that to the patient. Infection does spread easily in a hospital but when a patient who is in isolation insists on leaving their room to go outside, what are we supposed to do? Especially if we are afraid of receiving a low score.
Although my classmate makes a good argument regarding more information being available to the public, I believe it has to be done correctly and fairly. I don't agree with her take on patient satisfaction and hospital reimbursements. I think it would tie the hands of health care providers by making patient care all about the dollar sign instead of doing what is best for them. Hospitals should be held accountable for what they can control not by what they cannot. A person's perception of a situation should not hold a whole hospital responsible for trying to do their best.
http://www.kevinmd.com/blog/2012/02/patient-satisfaction-kill.html
http://www.nytimes.com/2012/03/15/opinion/hospitals-must-first-hurt-to-heal.html?_r=1