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Are for-profit hospital conversions harmful to patients and to Medicare?

We examine how changes in hospital ownership to and from for-profit status affect quality and Medicare payments per hospital stay. We hypothesize that hospitals converting to for-profit ownership boost post acquisition profitability by reducing dimensions of quality not readily observed by patients and by raising prices. We find that 1-2 years after conversion to for-profit status, mortality of patients, which is difficult for outsiders to monitor, increases while hospital profitability rises markedly and staffing decreases. Thereafter, the decline in quality is much lower. A similar decline in quality is not observed after hospitals switch from for-profit to government or private nonprofit status.

Diagnosis-Related Groups↗

Caritas Norwood Hospital: back from the brink.

Caritas Norwood Hospital and its affiliates went from $17 million in the red to a $4 million profit after implementing comprehensive financial and operational strategies, which included reengineering the revenue cycle, outsourcing some services, and focusing on the hospital's core business. External pressures were out of the hospital's control, but a comprehensive analysis identified many internal problems that the hospital had to resolve. The new management team also uncovered many undisclosed problems when it took the reins.

Accounts Payable and Receivable↗

[Treatment of mentally retarded in psychiatry].

The reform decentralizing the special care of the mentally retarded in Norway has caused concern within the Norwegian psychiatric community. The frequency of psychiatric disturbances and behaviour problems in this population is known to be high, and closing down special institutions may eventually direct more mentally retarded persons to psychiatric hospitals. Behaviour problems like poor communication skills, lack of social skills and self-care, and disruptive behaviours seem to cause more concern than the actual diagnosis. However, the same behaviour problems are found in psychiatric hospital populations, for instance among chronic schizophrenics. From a behaviour modification point of view these behaviours can be treated regardless of diagnosis. The article describes how a psychiatric hospital unit can apply behaviour modification resulting in a better life for an otherwise untreatable patient. It is recommended that behaviour modification techniques should be used concurrently with other methods of treatment used in psychiatry. As well as being potentially helpful to psychiatric patients, behaviour modification techniques will make psychiatry better equipped to treat mentally retarded people in need of psychiatric care.

Hospital Restructuring↗

Clinical management where medicine meets management. As good as new.

Diagnostic and treatment centres are providing a boost to community hospitals through improved technology and specialist skills. The first primary care DTC was opened by North Hampshire PCT last year. Plans in Bristol include a community DTC alongside an independent sector treatment centre and local authority leisure facilities.

Diagnostic Services↗

Mental health. Stepping stones.

Following a merger, Stepping Hill Hospital's psychiatric division had a bed occupancy of 130 per cent. In the next year, the wards will be converted to 23-bed single sex units. Staff shortages are thwarting the plans by delaying openings.

Adult↗