Quality - How
good is the hospital?
Each year, an
estimated quarter of a million patients (range 250,000 - 440,000) die from
medical errors. Millions more patients are affected from shabby care, bad
treatments, and poor services from hospitals. By asking “How good is this
hospital?” we are referring to the quality of care offered in hospitals. When
you pay attention to how good a hospital is, you can better protect yourself in
the hospital. It may even save your life.
Good hospitals do not
offer more expensive care, or necessarily have the newest technology, or offer
the latest tests and treatments. Rather, good hospitals provide care that is
safe, effective, patient centered, timely, efficient, and equitable. Here’s
some questions to ponder:
Is a beautiful building a good hospital?
There is an increasing
trend toward designing hospitals to appear like hotels. They have hotel-like
amenities such as waterfalls, pianos, big windows, and flower gardens. And,
there is an increasing trend of hiring staff with backgrounds in retail and
five-star hotels instead of patient safety
experience. The truth
be told, the nurses and doctors taking care of you are overworked and
understaffed. These are the people taking care of you on the front lines. So,
here are some points to consider:
1. Nurses are sometimes overworked and
overwhelmed, as hospitals force nurses to handle more patients than they
should. Tired nurses also have to deal with mandatory overtime as a staffing
tool, putting patient lives in jeopardy.
2. Teaching hospitals have doctors called
residents who are being trained to become specialists. These resident doctors
have 80-hour workweek limits, and suffer from fatigue and are more likely to
make mistakes.
3. Spiritual care is not a profitable area for
hospitals, so it gets cut.
Still, there are some
benefits to modern buildings such as reduced noise, improved natural light,
visitor friendly facilities, and well-decorated rooms.
Is doing expensive procedures a good hospital?
If your hospital
charges more than other hospitals, it does not mean that the hospital is good,
or the care you received was better. Administrative expenses eat up as much as 35 percent of total hospital expenses you pay for. Consider this:
1. Hospital CEOs and administrators are making
big bucks. CEOs make $400,000 to tens of million a year, not including benefits
like stock options.
2. Total health care spending in America was
approximately $3.5 trillion in 2017 and about 32 percent of that amount - or
$1.1-trillion - was spent on hospital services.
3. Hospital costs averaged $3,949 per day.
4. Each hospital stay cost an average of
$15,734.
Specialists can also
pad up your bill. Every time a specialist is consulted on your behalf, your
bill is being padded. Another example is the price of prescription drugs. If
the drug is name-brand or generic, it has the same active ingredients, but the
price difference can be extreme.
Is having the latest high tech a good hospital?
Everyone likes the
latest and greatest, especially when it comes to new technology. But often we
discover that tried and proven technology is better than the latest and
greatest. Consider the following:
1. According to the FDA, surgical mesh to repair
hernias injured 60,795 patients from 2008 to 2017.
2. During these same years, hip prosthesis
injured 103,104 patients.
3. Spinal cord stimulators injured 78,172 patients.
For years, medical
device companies and doctors have touted spinal-cord stimulators – devices that
use electrical currents to block pain signals before they reach the brain – as
great treatment for pain. Patients reported
that they have been shocked or burned or have suffered spinal-cord nerve damage
ranging from muscle weakness to paraplegia.
Is doing more tests a good hospital?
Laboratory tests are a
critical component of the assessment of patients for the diagnosis, monitoring,
and treatment of most diseases. Unfortunately, many factors figure into
hospital charges including the utilization of high-dollar tests, a lot of lab tests,
X-rays, and scans. It is the patients who end up paying for the indiscriminate
overuse of laboratory tests. This is called redundant testing and contribute to
unnecessary financial burdens on patients. Consider the following:
1. Unwarranted blood draws known as phlebotomy contribute
to hospital-induced anemia, and bigger hospital bills.
2. Similarly, CAT scans expose patients to
radiation that puts them at higher risk for developing cancer. Some research
has shown that even one CAT scan increases the odds that a person will develop
cancer.
3. A recent study found that there is somewhere
near a 30% overutilization rate for tests ordered.
4. The Institute of Medicine estimates that over
$200 billion a year are spent on tests and procedures that are unnecessary.
Doctors who work for
hospitals get financial incentives to over treat. At some hospitals, doctors
receive bonuses for more procedures performed and more expensive tests ordered.
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