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PubMed1984

Juggling multiple payers: American problems and foreign solutions.

The number and diverse methods of payers are among the principal causes of disarray in American hospital finance. Hospital managers are preoccupied with an intricate and deceptive shifting of costs among payers to maximize their revenues. In all other developed countries third parties cooperate, either voluntarily or by regulation, rather than try to shift costs to each other. In some countries third parties merge and hospital budgets are spread across all payers by standard calculations. In some countries with multiple payers, a common financial office administers all transactions with hospitals. The trend is to concentrate payment in a single source. Hospitals abroad are more stable than those in the United States. With stability, however, come inhibitions against risk, innovation, and failure.

Canada↗
PubMed1979

Reimbursing hospice care: a Blue Cross and Blue Shield perspective.

The Associations' "Initial Statement on Hospice Care and Payment for Hospice Services" comprises three criteria and many recommendations. The statement can guide local Plans and other third party payers, wary of repeating past mistakes that increased costs without improving care.

Blue Cross Blue Shield Insurance Plans↗
PubMed1994

Differences in treatment of ischemic heart disease at a public and a voluntary hospital: sources and consequences.

A study of hospital patients with ischemic heart disease reports that patients in a public hospital received fewer needed diagnostic tests, surgeries, and follow-up visits for their conditions than their private hospital counterparts. Factors in the hospitals' organizational environments and the patients' social backgrounds were observed to have an impact on content of treatment and to affect patient as well as provider perspectives on the quality of care. To facilitate the analysis, data were collected from four sources: direct observation of the care of each patient on rounds and at the bedside; interviews with physicians concerning the rationale for their decisions; a process-oriented chart audit assessing the appropriateness of care; and an extensive home interview with each patient three months following hospital discharge to establish further use of health services, health status, and satisfaction with care.

Ambulances↗
PubMed1976

Five-year retrospective study of hospitalization and treatment of patients with sickle cell anemia.

Examination of computerized hospital records of 463 admissions of 255 patients with sickle cell anemia was made. Patients ranged in age from infancy to 65, with a mean age of 17-7 years. Only 119 of the 255 patients were male, but 54% of the admissions were for males. Most patients were admitted to pediatrics and internal medicine services. Fluids and blood derivatives were given in over 60% of cases and anti-infection drugs in 40%. Mean hospital stay was 14.75 days, twice the mean for other patients. Thirty-six percent of the patients were admitted more than once. Mortality was 1.3% for the 463 admissions. Blue Cross or Medicaid accounted for payment in 51% of admissions. This information can be helpful to health planners providing comprehensive services for sickle cell patients.

Adolescent↗