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Results for “INDIGENT CARE”

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At least 19 recordsLinked to original sources
PubMed2002

Managing indigent care: a case study of a safety-net emergency department.

OBJECTIVE: To examine how one safety-net emergency department (ED) managed problems associated with the provision of indigent care in everyday life. DATA SOURCES/STUDY SETTING: Interview and observational data collected in County Hospital ED, a public teaching hospital in a California city, during 6 months of 1999. STUDY DESIGN: The study used ethnographic methods to document and understand day-to-day routines and practices for providing indigent care in a safety-net facility. DATA COLLECTION/EXTRACTION METHODS: One- to 2-hour semistructured interviews with a snowball sample of eight ED physicians were tape recorded, and fieldnotes were recorded in situ during 10-30 hours of participant observation per week in all areas of the ED. Data were coded to highlight themes of interest and to identify recurrent patterns of behavior. PRINCIPAL FINDINGS: In everyday life, providers at County ED relied on graduate medical education (GME) to manage two everyday problems, social use and tenuous financing, associated with the provision of indigent care. GME helped manage problematic social visits to time ED by defining them as interesting cases. GME helped with tenuous finances by creating a work culture that encouraged the provision of uncompensated work. CONCLUSIONS: Safety-net facilities often face problems similar to those in County ED. Future research should assess the extent to which the everyday management of these problems in County ED resembles that in other safety-net facilities.

California↗
PubMed1990

The distribution of indigent care among hospitals: in search of the fair share.

Although the magnitude and consequences of indigent care are well known, the terms and methods used to define and assess such care are less clear--yet these measures are vital to any solution of the problem. Using data from 151 Tennessee hospitals, two economists analyze the problems, concepts, views, and trends of indigent care and its distribution among hospitals.

Charities↗
PubMed1983

Indigent care limitation in university-owned hospitals.

In recent years the ability of teaching hospitals to finance the expenses associated with the provision of medical care to the indigent has come increasingly into question. Such concerns develop because of the burden cost shifting places on other patients and the potentially adverse market position resulting for the hospital. The University of Nebraska's experience in care for the indigent has been an economic success. The social, political, educational and ethical aspects of policies in this area, however, have not yet permitted definitive assessment.

Costs and Cost Analysis↗
PubMed2001

An incentive plan for professional fee collections at an indigent-care teaching hospital.

The authors describe the implementation and development of an incentive plan to improve professional fee collections at an indigent-care teaching hospital. They theorized that an incentive plan based on relative value unit (RVU) productivity would increase billings and collections of professional fees. Unique RVU targets were set for individual services based on the number of faculty full-time equivalents and average reported productivity for academic physicians by specialty. The incentive plan was based on the level of expected faculty billings, measured in RVUs, for each department. A "base + incentive" model was used, with the base budget being distributed monthly throughout the year, and the incentive held as a "withhold" to be paid at the year's end only if the billing target in RVUs was met. Additionally, a task force worked with physician billing office and the hospital to improve collections. In the first year after implementation of the system was in place, important increases were noted in total RVU productivity (30.5% over the previous year) and in collections (49.5% over the previous year). Sixteen of 23 departments exceeded their incentive targets, and it was possible to make distributions of professional fees to those departments, to be used within the hospital system to enhance clinical services. Moreover, the plan created an overall positive attitude toward billings and documentation of faculty activities. The authors believe that this kind of incentive plan will be increasingly important for academic faculty working in public hospital systems.

Efficiency↗
PubMed1989

The search for solutions to the indigent care crisis.

Providing care to the medically indigent is draining the financial resources of many hospitals. While a unified plan has yet to emerge from Congress, several proposals are being considered. These range from expanding Medicaid to requiring that employers provide a minimum level of healthcare benefits to employees. Meanwhile, states have begun to cope with the problem on their own. Special taxes, lotteries, supplements, and universal insurance plans are among the solutions being tested. Despite these efforts, the question of who will pay for those who cannot remains largely unanswered.

Economics, Hospital↗
PubMed1987

Nonprofit hospitals in a competitive environment: behavior in the Arizona indigent care experiment.

The initial expectations of a group of urban nonprofit hospitals about the implementation of a prepaid, competitively bid program for the provision of indigent medical care were that their participation in the program would be limited to the provision of inpatient care on a subcontracted basis. In reality, as the program evolved, nonprofit hospitals played an increasingly active role which included the provision of care as a primary contractor on a full, risk-sharing basis. This evolution in nonprofit hospital behavior resulted from a change in the overall hospital environment in the community, as well as the somewhat negative experience of the hospitals as subcontractors and a more realistic assessment of the benefits and costs from participating in the program.

Arizona↗