Page 16 - 2013 Hospitals/Systems Digest US.NMH.13.02.007
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HOSPI TALS
HOSPITALS/SYSTEMS DIGEST 2013
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
Data source: IMS Health © 2013
Key Takeaway
The Affordable Care Act links hospital Medicare reimbursement to quality outcomes for patients
with AMI, pneumonia and heart failure, with readmission rates being a key measure. A recent study
found that high occupancy in a CCU can lead hospitals to discharge such patients prematurely—
only to have these same patients readmitted.
1
Going forward, hospitals may seek to adjust their
patient flow protocols for those treated in CCUs in order to curb readmission rates.
• For each of the six diagnoses listed, average
length of stay (ALOS) per inpatient case was
longer at MHS hospitals than at non-MHS facilities,
especially for such cases of sepsis/pneumonia.
• At hospitals overall, ALOS was fractionally
longer for cases of acute myocardial infarction
(AMI) co-occurring with diabetes (3.7 days) in
2011 than for cases of AMI alone (3.6 days).
CCU Utilization Subsides Both at MHS and Non-MHS Hospitals
• Cardiac care unit (CCU) occupancy rates
and patient-days per hospital declined at
MHS and non-MHS hospitals alike in 2011, but
remained higher at MHS-owned hospitals.
• As average occupancy and patient-days per
hospital fell at non-MHS intensive care units (ICUs)
between 2010 and 2011, MHS hospitals reported
fractional growth in both ICU utilization measures.
UT I L I ZAT ION
CCU UTILIZATION, BY MHS OWNERSHIP
MHS Hospitals
Non-MHS Hospitals
ALL HOSPITALS
SERVICE VOLUME
2009
2010
2011
2009
2010
2011
2009
2010
2011
Average CCU Occupancy 66.9% 66.3% 65.4% 65.2% 64.5% 63.9%
66.5% 65.9% 65.2%
Average CCU Patient-Days
per Hospital
3,712 3,923 3,854 2,759 2,897 2,758
3,482 3,684 3,690
ICU UTILIZATION, BY MHS OWNERSHIP
MHS Hospitals
Non-MHS Hospitals
ALL HOSPITALS
SERVICE VOLUME
2009
2010
2011
2009
2010
2011
2009
2010
2011
Average ICU Occupancy 63.5% 62.1% 62.2% 56.6% 56.2% 53.8%
60.9% 60.0% 59.8%
Average ICU Patient-Days
per Hospital
4,042 4,076 4,107 2,675 2,643 2,227
3,515 3,549 3,537
AVERAGE LENGTH OF STAY (DAYS) PER CASE, by MHS Ownership
MHS Hospitals
Non-MHS Hospitals
ALL HOSPITALS
Diagnosis
2010
2011
2010
2011
2010
2011
AMI, Unspecified Site
4.0
3.8
3.1
3.2
3.6
3.6
AMI, Unspecified Site, Co-occurring
with Diabetes
3.8
3.8
3.6
3.4
3.8
3.7
Acute Infection (Sepsis/Pneumonia)
6.0
6.0
5.0
4.9
5.6
5.5
Acute Infection (Sepsis/Pneumonia)
Co-occurring with Diabetes
5.3
5.3
4.8
4.8
5.1
5.1
Heart Failure
4.8
4.9
4.4
4.3
4.6
4.6
Heart Failure, Co-occurring
with Diabetes
4.3
4.2
4.1
4.1
4.2
4.2
MHS Hospitals Record Longer ALOS for AMI, Heart Failure and Pneumonia
1
Singh, D., & Terwiesch, C. (2011). An Econometric Analysis of Patient Flows in the Cardiac Intensive Care Unit. Manufacturing and Services
Operations Management. Retrieved from
QUALITY SPOTLIGHT
