8 Reasons Why Hospitals Should Reduce Bed Volume

Cheryl Clark, for HealthLeaders Media , October 6, 2011

That's not consistent with the "systematic reform in healthcare that we at Dartmouth have been calling for, (which) is about keeping people healthy so they don't need to be in the hospital," he continued.

"It's about making sure patients make informed choices about major surgical procedures or elective procedures, and then right-sizing the healthcare system, which may very well lead to many, many fewer hospital beds and hospitals in this country. And that's how you would get lower costs."

2. More patients will be encouraged – perhaps through premium incentives – to sign advance directives. We know from research that treatment-limiting advance directives have the potential to prevent aggressive, expensive, but futile care at the end of life, especially in regions of the country where imminent death is more expensively and often painfully prolonged.

3. Doctors and nurses will get better at constraining healthcare-associated infections, thus reducing longer stays. They will get better at preventing falls, surgical mishaps, and other avoidable adverse events, in part because those will now be publicly reported and because that extra care those errors require will not be federally reimbursed.

4. More patients will be treated in outpatient settings, because accountable care organizations and coordinated outpatient services will make sure patients stay out of the hospital if they don't need to be there. Patients who do need hospital care will be discharged earlier because bundled payments will hasten that process.

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3 comments on "8 Reasons Why Hospitals Should Reduce Bed Volume"

OR MD MBA (10/8/2011 at 9:04 AM)
So lets take a routine patient. Grandma's not acting right, ends up being a mild UTI. Probably could go home by many standards but family is insistent. She was just in 3 wks ago with a generalized weakness/UTI so in reality it's a social admission b/c family can't deal with her right now. So, do I readmit her and get dinged or do I refuse the admission and piss off the family and get low satisfaction scores under HCAHPS. Oh, and while I'm spending all this time explaining why she can't be admitted, the waiting room is backing up increasing my wait times which is a new P4P CMS metric. Or better yet, I cave in and re-admit her and because there's less beds, she is now a hold in my ER. Can't wait for your rose colored healthcare world.

Lewis Allen (10/7/2011 at 9:26 PM)
I've performed laboratory work for a few decades now and believe you've missed the mark regarding hospitals and census counts. Hospitals are already closing beds, rooms and entire wings. Insurance providers have been forcing these closures for years as they decrease reimbursement for hospital services, jack up rates and/or deny coverage to patients, while ensuring they themselves receive 100 cents on the dollar as payment (ala Blue Cross/Blue Shield). Insurance providers have become the "attack dogs" for Socialist government policy, whose goal is to consolidate medical services into few, huge, "Centers of Excellence", where they can pay as little as possible for such "excellence". I assure you that patients are ill-served by having to travel 3 or 4 hours to a "center of excellence" for regular medical care. And let's not forget intense, Lawyer Greed, that has crippled physicians abilities to pay enormous premiums to simply "go to work". Physicians are forced to pass costs along or be forced into retirement. Fewer practicing physicians means worsening and unhealthy outcomes for needy patients.

JRG MD MBA (10/6/2011 at 7:56 PM)
Most of your analysis sounds like either wish fulfillment or you have been smoking something. Have you ever spent as much as a day providing any sort fo medical care?




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