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BIRTHS: About 10 percent of the 4 million births each year in U.S. are premature

The federal government collects statistics on all births in the United States.  Here are data for 2014 for premature births:

  • 3,988,076 total births in the United States
  • 381,321 (or about 10 percent of all births) were preterm (under 37 weeks gestational age)
  • Of those, 27,320 (or less than 1 percent of all births) were the most preterm (under 28 weeks gestational age)

The data are also presented according to birthweight:

  • 8 percent of all births in the United States in 2014 were LOW birthweight
  • 1.4 percent of all births were VERY LOW birthweight

Also interesting is PLACE OF BIRTH:

  • 3,988,076 total
  • 3,928,272 in the hospital
  •      38,094 at home
  •      18,219 freestanding birthing center

Source: Hamilton, B.E., Martin, J.A., Osterman, M.J.K., and others. (2015, Dec. 23). Births: Final data for 2014. National Vital Statistics Report. 64(12), 50, 53.  http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

CORPORATE CULTURE: How to encourage employees to speak freely about problems and ideas

It is not enough for managers to tell employees that they have an “open door policy.”  It is not enough to set up mechanisms that rely on anonymity to solicit opinion or reporting of problems.  The authors discuss aspects of the “fear factor” and the “futility factor” that tend to shut down communication from subordinates to managers about problems and new ideas for improvement.  Instead, it is suggested that managers can create a more vocal corporate culture by:

  • Asking for frequent feedback in a face-to-face setting and informally
  • Establishing transparent feedback processes
  • Encouraging new hires to contribute ideas based on their previous experience
  • Downplaying power cues
  • Setting an example in communicating with their own managers
  • Closing the loop

Source: Detert, J.R., and Burris, E.R. (2016, Jan.-Feb.). Can your employees really speak freely? Harvard Business Review, 94(1/2), 81-87.  https://hbr.org/2016/01/can-your-employees-really-speak-freely  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

FACILITY CLOSURE: What happens when rural hospitals close? How are facilities reused?

This is a study of 47 rural hospitals that closed in 2010 to 2014.  It comes out of the North Carolina Rural Health Research Program.  The authors compare characteristics of hospitals that closed completely – which they term as “abandoned” – with those that are no longer providing inpatient care, but now have some other health care-related use – which they term as “converted.”

Of the 47 rural hospitals that closed, a little over half (26 hospitals) were in the abandoned category, and most of these were located in the South – particularly in Texas, Alabama, and Georgia.  The authors found that abandoned rural hospitals tended to be in markets with a higher percentage of non-white population compared to those hospitals that were converted to other health care use.

There is an interesting table included that looks at characteristics of rural hospitals in the year of closure.  Hospitals in the abandoned category had the lowest total margin in that final year – negative 10 percent, while those that were converted to other health care use were in somewhat better financial condition.  All of the rural hospitals that closed were small, with roughly 25 to 30 beds.

Ten of these hospitals converted to freestanding emergency or urgent care facilities; 4 converted to skilled nursing or rehabilitation facilities; and 7 converted to outpatient care.  The perceived impact of losing an inpatient hospital in a community is that patients will have to travel further to obtain care, that jobs will be lost (since the rural hospital is often the largest employer), and a loss of prestige in the community.

Source: Thomas, S.R., Kaufman, B.G., Randolph, R.K., and others. (2015, Apr.). A comparison of closed rural hospitals and perceived impact. Findings Brief.  http://www.shepscenter.unc.edu/wp-content/uploads/2015/04/AfterClosureApril2015.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org


Patient and Family Engagement Resource Compendium

A new resource compendium links users to key resources on patient and family engagement. The resources, each briefly described, are grouped into these categories:

  • Leadership
  • Organizational assessments
  • Patient and family advisory council/committee: resources for hospitals
  • Partnering to improve the quality of care
  • Engaging patients and families during the hospital stay
  • Health literacy: resources for providers
  • Health literacy: resources to help patients communicate with providers and manage medications
  • Health literacy: resources to help patients prevent adverse events in the hospital
  • Shared decision making
  • Engaging to reduce disparities

The compendium also explains how the resources can help in getting started with a new program or initiative, and it ends with a general bibliography of additional article references.

Patient and family engagement resource compendium. Health Research & Education Trust, Dec. 2015. http://www.hret-hen.org/topics/pfe/20160104-PFEcompendium.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

CLOSURE: Why do rural hospitals close?

Characteristics of 42 rural hospitals that closed between 2010 and 2014 were compared to hospitals that remained open in this study out of the North Carolina Rural Health Research Program.

Rural hospitals that closed

  • Were in worse shape financially – lower margin, fewer days cash on hand, higher debt levels
  • Had a higher Medicare patient mix
  • Had lower utilization rates
  • Had lower volume in key services – surgery, outpatient services, and obstetrics
  • Had fewer employees

The researchers also took a look at critical access hospitals that closed compared to other rural hospitals that closed.

Source: Kaufman, B.G., Thomas, S.R., Randolph, R.K., and others. (2016, Winter). The rising rate of rural hospital closures. The Journal of Rural Health, 32(1), 35-43.  http://onlinelibrary.wiley.com/doi/10.1111/jrh.12128/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

50 Largest Medical Groups – 2016 Update

SK&A has updated its annual list of the nation’s 50 largest medical groups ranked by the number of affiliated physicians. At the top of this year’s list are:

  1. Kaiser Permanente Medical Group with 7948 physicians
  2. Cleveland Clinic with 2138 physicians
  3. Mayo Clinic with 1776 physicians
  4. Mercy Clinic with 1674 physicians
  5. North Shore-Long Island Jewish Medical Group with 1380 physicians

For each medical group included, the headquarters city/state, number of offices, and average number of physicians per office are also provided.

There are 294,115 physician offices in the U.S., according to the report. Over half of the offices have just one physician, and 90% of the physician offices have 5 or fewer physicians.

The report also has counts of physicians and office sites for 20 medical specialties as well as the number of offices according to daily patient volume ranges.

Source: Top 50 medical groups: market insights. SK&A/IMS Health, Jan. 2016. http://www.skainfo.com/health_care_market_reports/largest_medical_groups.pdf [free registration needed]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org


Projected Growth of Accountable Care Organizations

According to a new Leavitt Partners report, the number of accountable care organizations had grown to 782 by December 2015, covering 23 million lives.

What does future growth of ACOs look like? To find out, Leavitt staff made projections based on 4 different scenarios. In a baseline scenario that seemed most likely under current conditions, ACO coverage would reach 105 million people by 2020, but under ideal conditions, that number could reach 176 million lives [over half the population] in the next five years.

There’s been strong government support, including incentives and penalties, for accountable care organizations, but the future growth of ACOs remains unclear. That’s because the concept is still fairly new, and early results from ACOs so far have been mixed.

Despite the wide variation in growth projections for the four scenarios presented, the number of ACO covered lives grows in the five years ahead under each scenario.

Source: Muhlestein D and others. Projected growth of accountable care organizations. Leavitt Partners, Dec. 2015. http://leavittpartners.com/2015/12/projected-growth-of-accountable-care-organizations/ [free registration required to view]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org


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