Hospitals Misleading Patients About Benefits Of Robotic Surgery

From the 18 May Medical News Today article

An estimated four in 10 hospital websites in the United States publicize the use of robotic surgery, with the lion’s share touting its clinical superiority despite a lack of scientific evidence that robotic surgery is any better than conventional operations, a new Johns Hopkins study finds.

The promotional materials, researchers report online in the Journal for Healthcare Quality, overestimate the benefits of surgical robots, largely ignore the risks and are strongly influenced by the product’s manufacturer.

[An abstract of the article may be found here.
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“The public regards a hospital’s official website as an authoritative source of medical information in the voice of a physician,” says Marty Makary, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine and the study’s leader. “But in this case, hospitals have outsourced patient education content to the device manufacturer, allowing industry to make claims that are unsubstantiated by the literature. It’s dishonest and it’s misleading.”

Click here to read the rest of the Medical News Today article

Frequently hospitalized patients may benefit from new medical specialty focused on their needs

From the 29 April 2011 Eureka News Alert

Declining rates of hospitalization have discouraged primary care doctors from seeing their patients in the hospital and encouraged the growing use of “hospitalists,” a new physician specialty focused on the care of hospitalized patients. Further developments in the field mean that frequently hospitalized patients also may need a specialist focused on their care, according to an expert on hospital care at the University of Chicago.

The model defining the role of hospitalists, who practice only in hospitals, was first identified in a 1996 article in the New England Journal of Medicine, said David O. Meltzer, an associate professor of medicine and director of the University of Chicago’s Center for Health and the Social Sciences.

“Since that time, hospitalists have become the fastest-growing medical specialty in the United States, providing more than one-third of all general medical care in the United States,” Meltzer wrote in the paper, “Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States,” [full text link ]published by the National Bureau of Economic Research.

Meltzer discussed the growth of the field as well as the potential need for a new specialty — the comprehensive care physician, who would specialize in care of the seriously ill Friday at a conference organized by the Milton Friedman Institute at the University of Chicago. The conference, “Individuals and Institutions in the Health Care Sector,” also will look at issues such as technology and insurance.

The hospitalist specialty developed in response to the growing needs of severely ill patients, combined with reduced hospitalization of patients by general care or ambulatory physicians, Meltzer argues. As their number of hospitalized patients declined, general care physicians saw their travel costs loom large compared to the small number of hospitalized patients, Meltzer points out.

The use of hospitalists also has grown as hospitals have changed how they are reimbursed for their services, Meltzer contends. “Though the evidence that hospitalists produce savings is not consistent, it is clear that the growth of hospitalists accelerated as evidence to support cost-savings began to appear in the mid-1990s,” he said.

The use of hospitalists has the potential of creating communication problems, however, as these specialists do not always know the full medical histories of their patients as well as those patients’ general care physicians. The establishment of a specialty called the comprehensive care physician, or comprehensivist, could overcome that problem, Meltzer contends. The comprehensivist would work both in a hospital and an attached clinic and attend to those at greatest risk of hospitalization.

“Congestive heart failure, end-stage renal disease or liver disease, sickle cell disease or chronic-obstructive pulmonary disease might all be reasonable models for such care, especially if cases could be collected into centers of excellence with sufficient volume to support such degrees of specialization,” he said.

Although the comprehensivist model has yet to be introduced in the United States, it is similar to other approaches in Canada, the United Kingdom, Australia and New Zealand, he said.

Related Articles

• Specialty hospitalists joining forces with the generalist hospitalists (kevinmd.com)
• Should a hospitalist be given more information on hospital costs? (kevinmd.com)
• Hospitalist medicine is moving in the wrong direction (doctorrw.blogspot.com)
• What has the hospital medicine movement wrought? (medrants.com)

HCUP Facts and Figures: Statistics on Hospital-based Care in the United States

HCUP Facts and Figures 2008 Statistics on Hospital-Based Care in the United States, 2008

The number of patients who needed home health care after being discharged from hospitals surged by about 70 percent (2.3 million to 4 million) from 1997 to 2008.  [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Facts and Figures, Statistics on Hospital-Based Care in the United States, 2008.]

Some highlights from HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2008 

OVERVIEW STATISTICS FOR INPATIENT HOSPITAL STAYS	EXHIBIT
The number of hospital discharges increased from 34.7 million in 1997 to 39.9 million in 2008, a 15-percent increase overall, or an average annual increase of 1.3 percent.	1.1
Between 1997 and 2008, the aggregate inflation-adjusted costs for hospitalizations—the actual costs of producing hospital services—increased 61 percent. Costs rose from $227.2 billion to $364.7 billion—an average annual increase of 4.4 percent.	1.1
The average length of stay (ALOS) in 2008 (4.6 days) was almost 20 percent shorter than in 1993 (5.7 days). The ALOS declined throughout most of the 1990s and has remained unchanged since 2000.	1.2
Circulatory conditions were the most frequent major cause of hospital stays in 2008, accounting for 5.9 million stays or 15 percent of all discharges.	1.3
Even when pregnancy and childbirth stays are excluded, females accounted for more stays than males—18.6 million stays for females compared to 16.5 million stays for males.	1.3
Pregnancy and childbirth was the reason for 1 out of every 5 female hospitalizations (4.7 million stays).	1.3
Medicare and Medicaid were the expected primary payers for more than half (55 percent) of all inpatient hospital discharges.	1.4
Between 1997 and 2008, Medicaid discharges (up 30 percent) grew at double the rate of all discharges, followed closely by uninsured discharges (up 27 percent).	1.4
The number of discharges billed to Medicare grew by 18 percent.	1.4
Growth in the number of discharges billed to private insurance remained relatively stable (5 percent).	1.4
The number of discharges to home health care grew by 69 percent (1.6 million discharges) between 1997 and 2008.	1.5
Uninsured and Medicaid stays accounted for nearly half (48 percent) of all stays discharged against medical advice, but only about one-quarter (23 percent) of all stays in 2008.	1.5
Persons residing in the poorest communities had a 21-percent higher rate of hospitalization in 2008 (148 discharges per 1,000 population) than those residing in all other communities (122 discharges per 1,000 population).	1.6

(Obama Administration) Partnerships for Patients: Better Care, Lower Costs

From the HealthCare.gov Web page

Doctors, nurses and other health care providers in America work incredibly hard every day to deliver the best care possible to their patients.  Unfortunately, an alarming number of patients are harmed by medical mistakes in the health care system and far too many die prematurely as a result.

The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety and affordability of health care for all Americans.  The Partnership for Patients brings together leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates along with State and Federal governments in a shared effort to make hospital care safer, more reliable, and less costly.  The Partnership will help save 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years and has the potential to save up to $35 billion, including up to $10 billion for Medicare.  Over the next ten years, it could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings.  Already, more than 500 hospitals, as well as physicians and nurses groups, consumer groups, and employers, have pledged their commitment to the new initiative.

The two goals of this new partnership are:

• Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years.

• Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.  Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge….

…To see which organizations have already joined the Partnership, visitpartnershippledge.HealthCare.gov. …

…For more information about the Partnership for Patients, visitwww.HealthCare.gov/center/programs/partnership.  For more information about the Community-based Care Transitions Program funding opportunity visit: www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1239313.

Related Articles

• Ohio Campaign for Better Care Launches “Healthy Hospital” Initiative, Vows Vigorous Work to Improve Hospital Care for Vulnerable Older Patients (prnewswire.com)
• HHS in Campaign to Cut Hospital Errors (abcnews.go.com)
• Improving Care for People with Medicare (whitehouse.gov)
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