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FORECASTING: Discharges to decline 2 percent in 10 years

Our analytics are projecting a 2 percent decline in discharges over the next decade.  As a result, clients are challenging their perceived acute care footprint needs and increasingly reallocating resources to a variety of outpatient and virtual settings.”  Sg2

I always like to grab consultants’ forecasts – about nearly anything! – and feature them here.  However, it is doubly interesting when the forecasts are about hospital inpatient utilization.  This little snippet from Sg2 is part of an interesting conglomeration of opinion about the hospital of the future.   Becker’s Hospital Review interviewed 45 leaders with an interesting mix of affiliations – providers, consultants, vendors – about disruptors affecting the hospital field.

Source: Dyrda, L. (2017, July 17). 45 hospital and healthcare executives outline the hospital of the future. Becker’s Hospital Review.  Click here: https://www.beckershospitalreview.com/hospital-management-administration/45-hospital-and-healthcare-executives-outline-the-hospital-of-the-future.html  Posted by AHA Resource Center (312) 422-2003, rc@aha.org

DISRUPTION: PwC’s disruption profiler survey tool

This is a 16-question survey that allows an organization to take the temperature of disruptive forces in its industry.  The questions fall into the categories of:

  • Customer behavior
  • Production
  • Distribution
  • Competitors
  • Regulation

In a related analysis based on input from 268 executives in various industries, PwC found that CEOs report CUSTOMERS to be a more significant source of disruption than any of the other factors listed above.

Sources:

PricewaterhouseCoopers. (No date). Disruption profiler.  Click here: https://www.pwc.com/us/en/disruptionprofiler.html and,  PricewaterhouseCoopers. (2016?). The disruptors: How five key factors can make or break your business.  Click here: https://www.pwc.com/gx/en/ceo-agenda/pulse/the-disruptors.html  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

DISRUPTORS: ZocDoc joins others on top 50 disruptor list

This is the 5th year that CNBC has developed a list of private companies that have proved to be innovative disruptors in their market space.  This list focuses on start-ups that are challenging established large corporate competitors.  The top 5 companies listed include:

  1. Airbnb
  2. Lyft
  3. WeWork
  4. Grab
  5. Uptake Technologies

There is a patient-care-related company on the list – ZOCDOC.  This company allows patients to book physician office appointments similar to what OpenTable does for restaurant reservations.

Source: Meet the 2017 CNBC disruptor 50 companies. (2017, May 16). CNBC.  Click here: https://www.cnbc.com/2017/05/16/the-2017-cnbc-disruptor-50-list-of-companies.html  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

OPIOIDS: Drug overdose death rate doubles 2015 to 2016

These data on death rates from overdoses involving synthetic opioids other than methadone are drawn from the National Vital Statistics System, which is maintained by the U.S. National Center for Health Statistics (NCHS).  This includes fentanyl, fentanyl analogs and tramadol.

Synthetic Opioid Drug Overdose Death Rate (per 100,000 population)

  • 0.3  1999
  • 1.0  2013
  • 1.8  2014
  • 3.1  2015
  • 6.2 in 2016

Looking at the broader picture of drug overdose deaths from drugs of all types, the states with the highest overdose death rates in 2016 were: West Virginia, Ohio, New Hampshire and Pennsylvania.

Source: Hedegaard, H., Warner, M., and Minino, A.M. (2017, December). Drug overdose deaths in the United States, 1999-2016. NCHS Data Brief, 294.  Click herefor free full text: https://www.cdc.gov/nchs/data/databriefs/db294.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

OPERATING ROOMS: What are the 10 most costly procedures?

Here are data from the federal government’s Healthcare Cost and Utilization Project (HCUP) that compare different surgical procedures according the expense incurred by hospitals in providing them.  Here are some notes about the following – these data are for INPATIENT procedures only.  The data are for what it COSTS the hospital for the patient’s entire stay, not what the hospital charges for the stay.  These are ALL-PAYER data, which is good – the data are not limited to the Medicare population, for example.  Finally, the data are based on first-listed operating room procedures.

Top 10 Most Costly Surgical Operations: Mean Cost Per Stay, US, 2014

  1. $52,000  Heart valve
  2. $41,900  Coronary artery bypass graft
  3. $35,000  Pacemaker/cardioverter/defibrillator
  4. $34,600  Incision/excision central nervous system
  5. $34,300  Small bowel resection
  6. $28,900  Spinal fusion
  7. $23,700  Colorectal resection
  8. $21,500  Percutaneous coronary angioplasty
  9. $20,800  Amputation, lower extremity
  10. $17,500  Debridement of wound, infection, burn

Source: McDermott, K.W., Freeman, W.J., and Elixhauser, A. (2017, December). Overview of operating room procedures during inpatient stays in U.S. hospitals, 2014. Statistical Brief. Click here for FREE full text: https://hcup-us.ahrq.gov/reports/statbriefs/sb233-Operating-Room-Procedures-United-States-2014.jsp  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

OPIOIDS: Prescribing guidelines found helpful in Ohio

…our analysis demonstrates that emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians.”

In the two years before opioid prescribing guidelines were implemented in Ohio, emergency physicians were writing over 660,000 opioid prescriptions each year – of which roughly one-third of the prescriptions were for more than 3 days.  In 2012, statewide guidelines were issued.  By 2014, the most recent year studied, the total opioid prescriptions written by ED physicians had dropped to a little over 410,000.  Still about one-third were for more than 3 day prescriptions.

Source: Weiner, S.G., Baker, O., Poon, S.J., and others. (2017, December). The effect of opioid prescribing guidelines on prescriptions by emergency physicians in Ohio. Annals of Emergency Medicine, 70(6), 799-808.  Click here to purchased full text: http://www.sciencedirect.com/science/article/pii/S0196064417303530  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

EMERGENCY DEPARTMENT: Use of home-based care

Just over half of the 682 emergency physicians who responded to this 2015 survey indicated that they have chosen home-based care options (overseen by a nurse or physician) instead of observation stays or inpatient admissions for elderly patients who visit the emergency department.  This is not a frequent occurrence  – the majority of ED physicians reported doing this for 5 or fewer patients per month.  The most common barrier to home-based care after an ED visit was reported to be the sense of an unsafe or unstable environment at home.  Patients who were recommended most frequently for home-based care had these diseases or conditions:

  • cellulitis
  • urinary tract infection
  • diabetes
  • pneumonia, community acquired

Note: This is a medical journal article reporting the results of a survey.  The authors are with West Health Institute (La Jolla, CA) and UC San Diego Medical Center.

Source: Stuck, A.R., and others. (2017, November). National survey of emergency physicians concerning home-based care options as alternatives to emergency department-based hospital admissions. The Journal of Emergency Medicine, 53(5), 623-628.  Click here for free full text: http://www.jem-journal.com/article/S0736-4679(17)30488-2/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org