Surgery Complications, Hospital Care & Profits…A Connection?


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Questioning Hospital Care in the U.S.

Let’s face it, hospitals are big business. Hospitals are no longer the non-profit entities of the past. Many are for-profit corporations and thus drive profits with a focus on volume of patients, not necessarily quality.

The hospital industry is a powerful one, lobbying for pro-hospital laws across the country. That’s what happened with  Pennsylvania’s MCARE Act, which made it harder for patients to bring medical malpractice suits.

Related: Can a Pennsylvania hospital be sued for medical malpractice?

A new study published in the April 17, 2013 issue of the Journal of the American Medical Association, “Relationship Between Occurrence of Surgical Complications and Hospital Finances” found that hospitals generate more money from surgery patients who experience complications. Basically, hospitals get rewarded for making mistakes. This is exacerbated by the way hospitals are paid, not per patient, but literally, per procedure. If you study an itemized hospital bill, you will find that every last procedure is accounted for and billed. In addition, different departments, from radiology to the physician practice group, submit bills as well.

According to the study, “Depending on payer mix, many hospitals have the potential for adverse near-term financial consequences for decreasing post-surgical complications.” In other words, hospitals have a financial disincentive to decrease surgical complications.

Study researchers examined over 30,00 surgery patients in various hospitals in Texas and found that hospitals make more money when surgical patients experience preventable complications. In a very basic sense, hospitals stand to benefit when they make mistakes. The study findings support this. Out of the 30,000+ surgery patients in the study, researchers found that hospitals make more money from the patients who have complications.

Related: Philadelphia Hospital Safety Scores

Out of the hospital patients with private health insurance, those who suffered complications contributed/paid three times more than patients without complications ($55953 versus $16936).

Out of the Medicare patients, those who suffered complications paid two times more than patients without complications ($3629 versus $1880).

The reality is that hospitals operate like businesses. The hospital system must change its function and work towards decreasing surgical complications, not financially benefiting from them.

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