PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Hospital acquisitions leading to increased patient costs

2014-10-21
(Press-News.org) Berkeley — The trend of hospitals consolidating medical groups and physician practices in an effort to improve the coordination of patient care is backfiring and increasing the cost of patient care, according to a new study led by the University of California, Berkeley.

The counterintuitive findings, published today (Tuesday, Oct. 21) in the Journal of the American Medical Association, come as a growing number of local hospitals and large, multi-hospital systems in this country are acquiring physician groups and medical practices.

"This consolidation is meant to better coordinate care and to have a stronger bargaining position with insurance plans," said study lead author James Robinson, professor and head of health policy and management at UC Berkeley's School of Public Health. "The movement also aligns with the goals of the Affordable Care Act, since physicians and hospitals working together in 'accountable care organizations' can provide care better than the traditional fee-for-service and solo practice models. The intent of consolidation is to reduce costs and improve quality, but the problem with all this is that hospitals are very expensive and complex organizations, and they are not known for their efficiency and low prices."

Robinson teamed up with study co-author Kelly Miller, program analyst at Integrated Healthcare Association, a non-profit organization that promotes healthcare quality improvement, accountability and affordability in California.

The researchers analyzed four years of data, from 2009 to 2012, on 158 major medical groups and 4.5 million patients in California. Groups were put into three categories: owned by physicians, owned by a local hospital or hospital system, or owned by a large hospital system that spans multiple geographic markets in the state.

The measure of costs included physician visits, inpatient hospital admissions, outpatient surgery and diagnostic procedures, drugs, and all other forms of medical care except for mental health services. (The researchers did not have data on mental health services since they are paid for separately.)

After controlling for such factors as the mix of severely ill patients and geographic differences in cost, the researchers found that per patient expenditures were 19.8 percent higher for physician groups in multi-hospital systems compared with physician-owned organizations. Groups owned by local hospitals were better, but per patient costs still ran 10.3 percent higher compared with physician-owned groups.

Why would consolidation lead to increased costs? It could be that once a medical group has been acquired, physicians in those groups are expected to admit their patients to the high-priced hospital, Robinson said.

"Hospital-owned medical groups usually are expected to conduct ambulatory surgery and diagnostic procedures in the outpatient departments of their parent hospital, but hospital outpatient departments are much more costly and charge much higher prices than freestanding, non-hospital ambulatory centers," he said.

Robinson said that public policy should not encourage mergers and acquisitions as a means of promoting collaboration. Instead, he said, policymakers should consider supporting the use of bundled payments for hospitals and physicians to improve coordination of care.

"Hospitals are an essential part of the health care system, but they should not be the center of the delivery system," said Robinson. "Rather, physician-led organizations based in ambulatory and community settings are likely to be more efficient and provide cheaper care."

The study authors noted that their findings are limited to California, and that further studies should be done using data from other states.

"Nevertheless, these findings are important since California is the nation's leader in terms of having physicians participate in large medical groups that already perform the functions ascribed to 'accountable care organizations' by the Obama administration," said Robinson.

INFORMATION:

The Robert Wood Johnson Foundation provided support for this research.



ELSE PRESS RELEASES FROM THIS DATE:

This week from AGU: Rainfall and landslide risk, lava lake, winds hasten glacial melting

2014-10-21
From AGU's blogs: How rain falls – not just how much – may alter landslide risk New research finds that it's not just the amount of rain that falls on a hillside, but the pattern of rainfall that matters when trying to determine how likely a slope is to give way. This new information could improve forecasts of landslides, which are typically hard to predict, said the scientists conducting the research. Different rainfall patterns—a short, heavy deluge, a light, steady downpour, or sporadic showers—will trigger different numbers of landslides ...

Osteoporosis screening guidelines miss many younger post-menopausal women

2014-10-21
To reduce the risk of bone fractures and the complications arising from them, the United States Preventive Services Task force (USPSTF) recommends that all women age 65 and older be tested and treated for low bone mineral density. The task force also recommends that postmenopausal women aged 50 to 64, get bone mineral density screenings if their 10-year probability of suffering a hip, vertebral, humerus or wrist fracture is 9.3 percent or greater, based on the Fracture Risk Assessment Tool. A new UCLA-led study published in The Journal of Clinical Endocrinology & Metabolism, ...

New treatment resolves a hazardous airway complication in child with heart disease

New treatment resolves a hazardous airway complication in child with heart disease
2014-10-21
Philadelphia, Oct. 21, 2014 – A case study published recently in the journal Pediatrics describes an innovative, minimally invasive procedure that treated plastic bronchitis, a potentially life-threatening disease, in a six-year-old boy with a heart condition. Using new lymphatic imaging tools and catheterization techniques, physician-researchers eliminated bronchial casts, which are an accumulation of lymphatic material that clogged the child's airway. "Our technique represents a new treatment option for plastic bronchitis, which is a rare but often fatal complication ...

Immersed in violence: How 3-D gaming affects video game players

2014-10-21
COLUMBUS, Ohio – Playing violent video games in 3-D makes everything seem more real – and that may have troubling consequences for players, a new study reveals. Researchers found that people who played violent video games in 3-D showed more evidence of anger afterward than did people who played using traditional 2-D systems -- even those with large screens. The higher anger in 3-D players was connected to the fact that, compared to 2-D players, they were more likely to feel they were "immersed in the game," said Brad Bushman, co-author of the study and professor ...

Study shows how troubled marriage, depression history promote obesity

2014-10-21
COLUMBUS, Ohio – The double-whammy of marital hostility and a history of depression can increase the risk for obesity in adults by altering how the body processes high-fat foods, according to new research. In the study, men and women with a history of depression whose arguments with spouses were especially heated showed several potential metabolic problems after eating a high-fat meal. They burned fewer calories and had higher levels of insulin and spikes of triglycerides – a form of fat in the blood – after eating a heavy meal when compared to participants ...

Researchers identify new cell signaling pathway thought to play role in rheumatoid arthritis

2014-10-21
A new study by researchers at Hospital for Special Surgery (HSS) identifies a new cell signaling pathway that contributes to the development and progression of inflammatory bone erosion, which occurs in patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a systemic inflammatory autoimmune disease that affects millions of adults worldwide. Bone erosion in joints is a major cause of disability in RA patients. The study, titled "RBP-J imposes a requirement for ITAM-mediated costimulation of osteoclastogenesis," was published online in the Journal of Clinical ...

In disease outbreak management, flexibility can save lives and money

In disease outbreak management, flexibility can save lives and money
2014-10-21
A new approach for responding to and managing disease outbreaks is being proposed by a team of epidemiologists led by two Penn State University researchers. The team's flexible approach could save many lives and millions of dollars. The approach, called "adaptive management," allows decision-makers to use knowledge they gain during an outbreak to update ongoing interventions with the goal of containing outbreaks more quickly and efficiently. Current efforts to prevent or stem such outbreaks may fall short because of uncertainty and limited information about the real-time ...

Flexibility in disease outbreak management could save lives and money

2014-10-21
Research by a team of epidemiologists from the UK and the USA has proposed a new approach for responding to and managing disease outbreaks. They say lives and money could be saved if decisions are adapted to relevant information about the dynamics of the current crisis and not based on retrospective analyses of prior crises, trials and interventions. Dr Michael Tildesley, a lecturer in infectious disease modelling in the School of Veterinary Medicine and Science at The University of Nottingham and co-author of the paper, said: "Organisations involved in the outbreak of ...

Disease outbreak management -- flexibility can save lives and money

2014-10-21
What is the best way to handle a disease outbreak? Current efforts to prevent or stem such outbreaks may fall short because of uncertainty and limited information about the real-time dynamics of the specific disease outbreak. A team of epidemiologists, led by two Penn State University researchers, proposes a new approach for responding to and managing disease outbreaks -- a flexible approach that could save many lives and millions of dollars. The approach, called "adaptive management," allows decision-makers to use knowledge they gain during an outbreak to update ongoing ...

Most published medical research is false; Here's how to improve

2014-10-21
In 2005, in a landmark paper viewed well over a million times, John Ioannidis explained in PLOS Medicine why most published research findings are false. To coincide with PLOS Medicine's 10th anniversary he responds to the challenge of this situation by suggesting how the research enterprise could be improved. Research, including medical research, is subject to a range of biases which mean that misleading or useless work is sometimes pursued and published while work of value is ignored. The risks and rewards of academic careers, the structures and habits of peer reviewed ...

LAST 30 PRESS RELEASES:

EMBARGOED MEDIA RELEASE: Breathlessness increases long-term mortality risk, Malawi study finds

Permeable inspection of pharmaceuticals goes in-line

Warming rivers in Alaska threaten Chinook salmon populations and Indigenous food security

New multi-disciplinary approach sheds light on the role of mitochondrial DNA mutations in cancer

Worms reveal just how cramped cells really are

Alzheimer’s disease digital resources lacking for Latinos, Hispanics in Los Angeles years after COVID-19, study finds

Chronic disease deaths decline globally, but progress is slowing

The Lancet: Chronic disease deaths decline globally, but progress is slowing

The Lancet: Parent-focused programs insufficient to prevent obesity in toddlers, finds meta-analysis; authors call for a re-think of childhood obesity prevention approaches

Study sheds light on hurdles faced in transforming NHS healthcare with AI

Astrocytic “brake” that blocks spinal cord repair identified

As farm jobs decline, food industry work holds steady

Kennesaw State researcher aiming to move AI beyond the cloud

Revolutionizing impedance flow cytometry with adjustable microchannel height

Treating opioid addiction in jails improves treatment engagement, reduces overdose deaths and reincarceration

Can’t sleep? Insomnia associated with accelerated brain aging

Study links teacher turnover to higher rates of student suspensions, disciplinary referrals

How harmful bacteria hijack crops

Crowded conditions muddle frogs’ mating choices

A new way to guide light, undeterred

Researchers uncover how COVID-19 may linger in cancer patients and affect treatment outcomes

Tiny metal figurines from Sardinia's Nuragic civilization in around 1,000 BC reveal extensive ancient Mediterranean metal trading networks

Natural microfibers may degrade differently to synthetic materials under simulated sunlight exposure in freshwater and seawater conditions, with implications for how such pollutants affect aquatic lif

Indian new mums report better postpartum wellbeing when their own mum acts as their primary support - while women whose mother-in-law is the primary caregiver instead report significantly lower overal

Young adult intelligence and education are correlated with socioeconomic status in midlife

Traditional and “existential” wellness vary significantly between US regions

Smartwatches detect early signs of PTSD among those watching coverage of the Oct 7 attacks in Israel

The pandemic may have influenced the trainability of dogs, as reported by their owners

The withdrawal of U.S. funding for tuberculosis could lead to up to 2.2 million additional deaths between 2025 and 2030 inclusive

A ‘universal’ therapy against the seasonal flu? Antibody cocktail targets virus weak spot

[Press-News.org] Hospital acquisitions leading to increased patient costs