Hospital systems and organizational structures

Hospitals

Public hospitals have for a long time provided the safety net for the health care of the poor urban as well as suburban societies, whose members do not have the health insurance facilities or the money required to pay the ever-increasing medical bills. However this safety net could now be considered to be something of the past in case the public hospitals tend to keep closing down, according to a report published by the Downstate Medical Center of the State University of New York - SUNY in the year 2005. (Public hospitals face extinction in urban -- and suburban -- areas; study finds wealthiest communities have the best access to healthcare) as per a report from the HHS Office of Inspector General -- OIG, during 2000, 64 general, short-term, critical care hospitals which stand for 1.4% of all U.S. hospitals faced closure. Even though an identical number of hospitals were closed in the years 2000 and 1999, 29 hospitals were opened or reopened during 2000, which is seven more, compared to the year 1999. 22 of the hospitals which faced closure were situated in rural regions, and 42 were situated in urban regions. Although several factors were responsible for the closure of the hospitals, the most common explanation reported were financial problems because of low occupancy as well as competition. Besides hospital reorganizations as well as Mergers and Acquisition -- M&a were responsible for 19 cases of closure. (Hospital closure rate remains level) the details of the state wise hospitals showing its number, staffed beds, total discharges, patient days and the Gross Patient Revenue in $000 is shown in Appendix - I of which many are facing the issue of being closed down. (Hospital Statistics by State)

Now let us examine the causes of errors and barriers for providing safe care. A lot of studies are available examining the impact of closure on hospital costs, normally finding a direct correlation between incompetence and shutting down. Mobley and Frech in the year 1994 stated that anticipated future growth as well as size was important triggers for closure. Deily, McKay, and Dorner in 2000 analyzed that hospital inefficiency was responsible for a significant extent of the chances of closure. Likewise, Ciliberto and Lindrooth in the year 2006 discovered that hospital efficiency was an important forecaster of hospitals facing closure. Besides, they also revealed that third party payment charities powerfully forecasted closures, recommending that hospitals which were efficient but which were poorly reimbursed were likely to face closure. The liberality of private insurers would possibly go up with the value which a hospital presents itself to the market, since highly valued hospitals can normally bargain more favorable rates. (Capps; Dranove; Lindrooth, 2006) Let us now discuss some of the causes of errors and the barriers to providing safe care which are Accreditation issues, Partnership, Physician-hospital organization issues and Medical errors.

Accreditation issue was an important factor causing errors and barriers to providing safe care thereby finally resulting in closure of hospitals. Accreditation in hospitals could be considered as the method by which the services provided by the hospital is being measured to understand as to whether it is providing high quality services, so that the people could have faith in the services provided by the hospital. As a result of low quality being provided, several hospitals were being faced with the problem of cutting their funds being issued from the Joint Commission on Accreditation of Healthcare Organizations - JCAHO. (Munoz, 2005) With regard to Accreditation issues, the Joint Commission on Accreditation of Healthcare Organizations -- JCAHO in July 2002 recommended standardized performance measures which were intended to measure the performance of accredited hospitals and encourage improvement in health care quality. JCAHO investigated hospital's performance on 18 standardized indicators of the quality of care for acute diseases. In order to deal with the problems in the healthcare system, the report desired for establishment of monitoring and evaluation procedures for assessing the progress of the health care system. (Williams; Schmaltz; Morton; Koss; Loeb, 2005)