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Crossroads in hospital conversions--a survey of nonprofit hospital conversion legislation.

Mr. Donohue discusses the history of nonprofit hospital conversions in the United States and analyzes the National Association of Attorneys General's Model Conversion Act. In addition, this article surveys conversion-related legislation of 17 states plus the District of Columbia. Finally, Mr. Donohue recommends the implementation of adequate safeguards to insure that nonprofit hospital assets are maximized and to insure that the subsequent use of conversion proceeds continues to fulfill the original charitable mission of the nonprofit hospital.

Charities↗

Impact of postpartum hospital-stay legislation on newborn length of stay, readmission, and mortality in California.

OBJECTIVES: The objectives of this study were to examine the impact of postpartum hospital-stay legislation on newborns' length of stay, neonatal readmissions, and 1-year mortality in California, and whether this legislation had differential impacts by demographics and complications during delivery or pregnancy. METHODOLOGY: This study used linked birth certificates, death certificates and hospital discharge records for all full-term, normal birth weight, and singleton-birth newborns during 1991-2000 in California (n = 662,753). Interrupted time-series analyses were used to examine changes in newborns' length of stay and outcomes after 1 year, 2 years, and 3 years since the passage of postpartum laws. Multivariate linear and logistic regressions were estimated separately by maternal characteristics (race, education, age, and partity), delivery type, and complications during pregnancy or delivery. RESULTS: Length of stay increased by 9.5, 12, and 14 hours in years 1, 2, and 3, respectively, after the passage of the law. Increases were larger for newborns of white mothers, more educated mothers, mothers >35 years of age, primaparous mothers, cesarean deliveries, and Medicaid recipients, but there were no differences by pregnancy or delivery complications. The odds of neonatal readmission declined by 9.3%, 11.8%, and 19.7% in years 1, 2 and 3 after the law, respectively. The odds of infection-related readmissions declined by 21.5% and 30.3% in years 2 and 3, respectively. The odds of jaundice-related readmissions increased by 7% in year 1. There was no significant change in either the odds of readmission due to respiratory problems or the odds of 1-year mortality in the postlaw years. Demographic differences in the impact of the law on readmissions and mortality could not be detected because of lack of statistical power. CONCLUSIONS: Postpartum length of stay legislation was associated with increased length of stay among all births in California, with significant variation in the law's impact across demographic groups. After the law's passage, there was a significant decline in neonatal readmissions but not in 1-year mortality.

California↗

[Controlling in clinical management].

Managers of industrial enterprises strive continually to improve the efficiency of production, distribution and service for their customers in order to be able to compete on the market. In socially orientated non-profit-organisations this is not universe practice. Relating to section 17 Abs. 1 KHG and section 13 BPfIV of German social legislation hospital charges are refunded only, if the hospital is working efficiently and economically. Controlling is a tool to achieve these goals. Controlling coordinates the flow of information for planning and evaluation. Strategic and operative controlling are closely interrelated: Strategic controlling is directed towards new and promising activities, operative controlling supports decision--making--including future-oriented aspects-by providing and condensing information. Controlling is definitely not intended to dictate or "command" any action. Its object is to serve as an instrument or tool supporting result-oriented planning, regulating and evaluation.

Germany↗