Abstract
This study focused on hospital populations which account for large amounts of health care utilization at the community level in the metropolitan area of Syracuse, New York. It demonstrated that, between the two largest hospital inpatient services, adult medicine patients accounted for a larger number of excess hospital patient days than adult surgery over a two-year period. Adult medicine stays increased while adult surgery stays declined. Adult medicine also accounted for a larger number of excess inpatient days, an average daily census of 52.7 patients in 2013, although adult medicine outliers comprised only 2.4 - 2.5 percent of discharges while adult surgery patients comprised 4.4 - 4.5 percent of discharges for these services. Adult medicine readmissions accounted for 79 - 81 percent of these adverse events for the combined hospital during the two-year period. Adult medicine complications accounted for 60 - 62 percent of complications in the two hospitals for which data were available. These data clearly demonstrate the challenges that adult medicine patients carry for providers as they attempt to improve the efficiency and outcomes of care in local communities. In the United States, payer reimbursement for the care of these patients frequently does not match the resources required as funding emphasizes surgical specialties and healthier patients. In metropolitan areas such as Syracuse, where local populations are aging or declining, the expenses of caring for these patients can become a major challenge for community providers.
Highlights
In recent years, increased attention has focused on improving the efficiency and outcomes of health care in the United States and other western nations
This study focused on hospital populations which account for large amounts of health care utilization at the community level in the metropolitan area of Syracuse, New York
As efforts to improve the efficiency of health care continue, the care of adult medicine patients within the limits of available resources may become a greater challenge
Summary
In recent years, increased attention has focused on improving the efficiency and outcomes of health care in the United States and other western nations. This development has been supported by a recognition that the quantity. Rising health care expenses in the United States created incentives for improving the efficiency of care. These expenses led to the implementation of health maintenance organizations and hospital payments per discharge in the twentieth century, as well as Accountable Care Organizations and provider productivity adjustments in the twenty first century [3]. The collective impact of these and other mechanisms has been associated with a reduction in the rate of growth of health care expenses in the United States [4] [5]
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