Fewer patient admissions a symptom of health-care ‘transformation,’ study says
BY MONIFA THOMAS Staff Reporter March 23, 2014 5:14PM
Sun-Times Media Library
Updated: April 25, 2014 6:13AM
In announcing its plan Thursday to sell Our Lady of the Resurrection Medical Center to a new buyer, Presence Health cited financial challenges in part due to fewer people being admitted to the Catholic hospital.
That certainly isn’t a problem unique to Our Lady of the Resurrection. Patient admissions are down across the region, according to an online report by the journal Health Affairs, part of what the report cites as a “transformation” in health care.
Figures from 2010 show that 71 Chicago-area hospitals covering seven counties discharged about 1.02 million patients; by 2012, that number had dropped about 5 percent, to 970,000 discharges, according to the January report.
Researchers looked at inpatients — those admitted for treatment requiring an overnight stay — as well as outpatients, who are treated at the hospital or other facilities but not admitted.
Fewer patients are treated as inpatients anymore, said Robert York, a senior vice president at Kaufman Hall who led the research.
“It’s not so much that they are not in the hospital. They’re just not inpatients in the hospital,” York said. “What needs to be left is really a strong outpatient ambulatory, other-care network in the place of this.”
The Affordable Care Act — known informally as Obamacare — “is a big part” of the move away from inpatient care, especially the federal government’s push for creating “accountable care organizations” and a new penalty for readmissions, said Danny Chun, a spokesman from the Illinois Hospital Association. He was not involved in the study.
Accountable care organizations are groups of doctors, hospitals and other health care providers, who work together to ideally provide better care while avoiding unnecessary duplication of services.
“That’s not necessary in the old traditional inpatient acute care settings in the hospitals,” Chun said.
The federal government also started penalizing hospitals with avoidable hospital readmissions in 2012, so hospitals are doing a better job of keeping patients from coming back.
Declining volumes of inpatients are not a new issue, though. Chicago-area hospitals, like hospitals nationwide, have seen that number dropping for years.
Experts said other reasons include fewer visits to the hospital because of a struggling economy and fewer children being born in the United States. So-called “observation care” — a step up from the emergency room but a step down from a formal hospital — is also becoming more common and likely decreasing the number of inpatients.
Adding a double-whammy to the decreasing volume of inpatients is that more of the patients who are admitted to hospitals tend to be covered by Medicare or Medicaid. Both often pay less than private insurance.
Combating these and other factors means that health care systems, including hospitals, must change if they want to “survive in the short-term and thrive in the long-term,” Chun said.
“Nobody has the magical answer to everything,” he said. “So they’re all working on these various approaches . . . these new models of health care delivery.”