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FORECASTING: How to predict closure of rural hospitals

From January 2010 to December 2015, 63 rural hospitals closed, and over 1.7 million people are now at greater risk of negative health and economic hardship due to the loss of local acute care services.”

A model to predict financial distress and the risk of closure for rural hospitals is described in this scholarly article out of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.  The model was validated in that all of the selected financial performance indicators were found to be associated with the likelihood of hospital financial problems.  A surprise was that investor-owned rural hospitals were found to be more likely than expected to be in financial distress; although, this might be linked to their tendency to be located in southern states, which – as a region – are more likely to be struggling financially.

Source: Holmes, G.M., Kaufman, B.G., and Pink, G.H. (2017, Summer). Predicting financial distress and closure in rural hospitals. Journal of Rural Health, 33(3), 239-249.  Click here for access to the publisher’s website: http://onlinelibrary.wiley.com/doi/10.1111/jrh.12187/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

POPULATION HEALTH: How many diabetics in 2030?

The team finds that in spite of medical advances and prevention efforts, diabetes presents a major health crisis in terms of prevalence, morbidity, and costs, and that this crisis will worsen significantly over the next 15 years.

An estimated 54.9 million people will have diabetes in the U.S. in the year 2030, compared to 35.6 million in 2015, according this study from the Institute for Alternative Futures.  This represents a 54 percent increase.  The prevalence of diabetes will represent a cost to the nation of over $622 billion in 2030 (calculated in 2015 dollars), up from roughly $408 billion in 2015.  Maps included in the article show some clustering projected for 2030 – states with higher proportions of diabetics are in the southeast, southwest, and Rust Belt regions.

Source: Rowley, W.R., and others. (2017, February). Diabetes 2030: Insights from yesterday, today, and future trends. Population Health, 20(1), 6-12.  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278808/pdf/pop.2015.0181.pdf.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Number of System-Affiliated vs Independent Community Hospitals, 1999-2015

System-affiliated hospitals outnumber those that remain independent. In 2015, 66% of community [acute care, non-federal] hospitals were affiliated with a health care system. This compares to 51% in 1999. Conversely, 34% of community hospitals were independent facilities in 2015, down from 49% in 1999.system-vs-nonsystem-comm-hosp-fy15

 system-vs-nonsystem-comm-hosp-fy15-chart

Sources:

Fast facts on US hospitals: pie charts. American Hospital Association, Jan. 2017. http://www.aha.org/research/rc/stat-studies/Pie-charts2017.shtml

Table 2.1: Number of community hospitals, 1991-2014. In: Trendwatch Chartbook 2016, American Hospital Association, May 12, 2016. http://www.aha.org/research/reports/tw/chartbook/2016/table2-1.pdf. Related chart 2.4: Number of hospitals in health systems, 2004-2014: http://www.aha.org/research/reports/tw/chartbook/2016/chart2-4.pdf

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

SURGERY: Use of surgical robots has changed the way radical prostatectomy procedures are done in the U.S.

The volume of radical prostatectomy procedures decreased 7 percent from 1425 procedures per million men over age 45 in the late ’90s to 1330 per million in 2010-2011.  There was a big change, however, in the way that the surgery was performed as surgical robots came to the fore in urological surgery.  This study of national data shows that open radical prostatectomy procedures dropped from 1424 per million older men to 435 per million during the 14-year time period.  Much of that procedure volume was moved over to robotic surgery.

This study also analyzes hospital procedure volume – finding that 18 percent of hospitals stopped providing open radical prostatectomy since 2006.  The number of hospitals providing the minimally invasive version of the procedure increased by 191 percent during the same period.  The percentage of hospitals with a low-volume (fewer than 50 procedures) program of minimally invasive radical prostatectomy doubled – to 26 percent – by the end of the study period.

Source: Tyson, M.D., and others. (2016, Jan.). Radical prostatectomy trends in the United States: 1998 to 2011. Mayo Clinic Proceedings, 91(1), 10-16.  Click here for full text: http://www.mayoclinicproceedings.org/article/S0025-6196%2815%2900771-5/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Top 10 Patient Safety Concerns for Healthcare Organizations for 2016

The ECRI Institute has released its annual ranking of the top patient safety concerns for healthcare organizations. Based on a review of its patient safety organization [PSO] database of reported safety events, its PSO members’ root cause analyses and research requests, and a vote by an expert panel, these are currently the top issues:

  1. Health IT configurations and organizational workflow that do not support each other
  2. Patient identification errors
  3. Inadequate management of behavioral health issues in non-behavioral-health settings
  4. Inadequate cleaning and disinfection of flexible endoscopes
  5. Inadequate test-result reporting and follow-up
  6. Inadequate monitoring for respiratory depression in patients prescribed opioids
  7. Medication errors related to pounds and kilograms
  8. Unintentionally retained objects despite correct count
  9. Inadequate antimicrobial stewardship
  10. Failure to embrace a culture of safety

Source: Top 10 patient safety concerns for healthcare organizations 2016: executive brief. ECRI Institute, April 2016. www.ecri.org/patientsafetytop10 [free registration required]

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

Accountable Care Organizations in 2016: Private and Public-Sector Growth and Dispersion

There were 838 active accountable care organizations as of January 2016, and they have service areas in every state. That’s all according to a new analysis by Levitt Partners  and the Accountable Care Learning Collaborative. The count of ACOs has grown from 64 in early 2011, and has increased 12.6% just over the past year. The number of accountable care contracts is now at 1,217, and an estimated 28.3 million people are covered by an accountable care arrangement.

The report also charts:

  • ACOs over time
  • ACOs by state
  • ACOs by hospital referral region
  • ACO lives over time
  • ACO lives per payer type
  • ACO penetration by state
  • ACO penetration by hospital referral region

ACO contract renewals and dropouts, policy drivers, ACO challenges, and the future of accountable care are all discussed briefly.

Source: Muhlestein D; McClellan M. Accountable care organizations in 2016: private and public-sector growth and dispersion. Health Affairs Blog, April 21, 2016. http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/

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

ROBOTICS: How many robotic surgery procedures per year?

This is an infographic with interesting tidbits about the dispersion of the da Vinci surgical robot – the market leader in robotic laparoscopic surgery.  Here is a look at the market (there are other vendors, but this is looking at the da Vinci):

  • One quarter of US hospitals have one or more da Vinci robots
  • 79 percent of procedures using a da Vinci robot are done in the US
  • 570,000 da Vinci robotic procedures worldwide in 2014
  • This is a 178 percent increase worldwide in 5 years
  • 450,000 da Vinci robotic procedures: US 2014
  • Here is a distribution of the types of da Vinci robotic procedures: 52 percent are gynecological; 24 percent are general surgery; 20 percent are urological; and 4 percent are other
  • Incremental cost per procedure using da Vinci ranges from $3,000 to $6,000.

Source: ECRI Institute. (2015). Robotic surgery: Arm yourself with the latest information on pricing, performance, clinical efficacy, and safety.  Click here for free full text:  https://www.ecri.org/Resources/ASG/Robotic_Surgery_Infographic_MS15369_web.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org