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TygrBright Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-25-11 01:30 PM
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The Article the For-Profit Healthcare Sector SERIOUSLY Doesn't Want You (or Anyone) to Read
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The Hot Spotters

...Besides looking at assault patterns, he began studying patterns in the way patients flowed into and out of Camdens hospitals. Id just sit there and play with the data for hours, he says, and the more he played the more he found. For instance, he ran the data on the locations where ambulances picked up patients with fall injuries, and discovered that a single building in central Camden sent more people to the hospital with serious fallsfifty-seven elderly in two yearsthan any other in the city, resulting in almost three million dollars in health-care bills. It was just this amazing window into the health-care delivery system, he says.

So he took what he learned from police reform and tried a Compstat approach to the citys health-care performancea Healthstat, so to speak. He made block-by-block maps of the city, color-coded by the hospital costs of its residents, and looked for the hot spots. The two most expensive city blocks were in north Camden, one that had a large nursing home called Abigail House and one that had a low-income housing tower called Northgate II. He found that between January of 2002 and June of 2008 some nine hundred people in the two buildings accounted for more than four thousand hospital visits and about two hundred million dollars in health-care bills. One patient had three hundred and twenty-four admissions in five years. The most expensive patient cost insurers $3.5 million.

Brenner wasnt all that interested in costs; he was more interested in helping people who received bad health care. But in his experience the people with the highest medical coststhe people cycling in and out of the hospitalwere usually the people receiving the worst care. Emergency-room visits and hospital admissions should be considered failures of the health-care system until proven otherwise, he told mefailures of prevention and of timely, effective care.

...Could anything that dramatic happen here? An important idea is getting its test run in America: the creation of intensive outpatient care to target hot spots, and thereby reduce over-all health-care costs. But, if it works, hospitals will lose revenue and some will have to close. Medical companies and specialists profiting from the excess of scans and procedures will get squeezed. This will provoke retaliation, counter-campaigns, intense lobbying for Washington to obstruct reform.

A truly revolutionary idea: Save money by doing GOOD health care, rather than NO health care. But it would reduce or eliminate profit margins for a lot of people getting rich off of providing bad health care and no health care now, so what are the odds that anyone will actually learn from this work?

Let's just say that if it were a horse at Pimlico, I'd definitely box it in an exacta with the favorite. And then kiss my money good-bye...

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  -The Article the For-Profit Healthcare Sector SERIOUSLY Doesn't Want You (or Anyone) to Read TygrBright  Apr-25-11 01:30 PM   #0 
  - i guess it depends what the goal is. because we are now 'customers' instead of paitients  ejpoeta   Apr-25-11 01:37 PM   #1 
  - My 3-part model for health care:  Ron Green   Apr-25-11 01:38 PM   #2 
  - COMMIE! How can any system be fair unless unlucky people suffer? n/t  FormerDittoHead   Apr-25-11 01:43 PM   #4 
  - I hope you will consider a 4) Autonomous, self-renewing, accountable commitments to professional  patrice   Apr-25-11 01:47 PM   #5 
  - Excellent! (Although that might be included in a comprehensive  Ron Green   Apr-25-11 01:54 PM   #7 
     - I like the sorts of things that Edward Deming created for this.  patrice   Apr-25-11 02:02 PM   #8 
        - I like this idea because it focuses on quality assurance...  midnight   May-01-11 08:39 PM   #23 
  - Oh Yeah??  BobbyBoring   Apr-25-11 02:16 PM   #10 
  - That is not what he said.  MedicalAdmin   Apr-26-11 10:48 AM   #16 
  - HURRAH!!  GTurck   Apr-26-11 02:22 PM   #17 
  - Another aspect of the costs is related to staffing shortages & the stratification of "care".  patrice   Apr-25-11 01:43 PM   #3 
  - And the ones who ARE stable, the ones who don't get churned, have a major incentive to  patrice   Apr-25-11 01:51 PM   #6 
  - And the staffing shortages are driven by pressures on the quality of care. nt  patrice   Apr-25-11 02:15 PM   #9 
  - Kick for tonight. n/t  hootinholler   Apr-25-11 03:45 PM   #11 
  - A simple "meals on wheels" program for the elderly....  Scuba   Apr-25-11 05:29 PM   #12 
  - So fix the stairs already.  fasttense   Apr-26-11 07:04 AM   #13 
  - Lotta building code violations  supernova   Apr-26-11 08:50 AM   #14 
     - Code? In Massachusetts? New England?  catrose   Apr-26-11 10:02 PM   #20 
  - Wow, I'd want to work for someone like this  supernova   Apr-26-11 10:17 AM   #15 
  - Sounds like European model, go figure  NothingRight   Apr-26-11 04:48 PM   #18 
  - one patient with 324 admissions in five years equals fraud  onethatcares   Apr-26-11 05:30 PM   #19 
     - Blame the perp- not the program-  999998th word   Apr-26-11 11:51 PM   #21 
     - Data is inconclusive  supernova   Apr-27-11 12:37 PM   #22 

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