Ohio Health Policy Review

OHA: Childbirth, chest pain, top reasons for admittance to Ohio hospitals

According to the Ohio Hospital Association, childbirth was the number one reason patients were admitted to Ohio hospitals in 2006 without going through an emergency department (ED). (OHA HealthBeat newsletter, March 2008). In that year, Ohio hospitals delivered 156,952 babies. For patients admitted to state hospitals through an emergency department, chest pain was the number one reason. According to the OHA, "among the 45% of patients who are admitted through the ED, pneumonia and chronic bronchitis were also major reasons for longer hospital stays. These conditions point to an aging demographic, with more than 42% of patients admitted through the ED at age 66 or older and nearly 78% at age 41 or older."

Top reasons patients are admitted to Ohio's hospitals (NOT through an ED)

1. Childbirth
2. Heart-related problems
3. Joint-related conditions
4. Pneumonia
5. Rehabilitation needs

Top reasons patients are admitted to Ohio's hospitals (through an ED)

1. Chest pain
2. Pneumonia
3. Heart-related problems
4. Obstructive chronic bronchitis
5. Renal failure

Eleven Ohio hospitals named among nation's top 100

The new Thompson 100 Top Hospitals listing has been released, ranking the nation's top hospitals using an analysis of the last two years of performance data on eight measures of clinical quality, operating efficiency and financial performance. A number of Ohio hospitals made the top 100. MetroHealth Medical Center and University Hospitals Case Medical Center, both in Cleveland, were listed among the best major teaching hospitals; Fairview Hospital in Cleveland, Kettering Medical Center in Kettering, Grandview Medical Center in Dayton, Good Samaritan Hospital in Cincinnati, Bethesda North Hospital in Cincinnati, and Hillcrest Hospital in Mayfield Heights were listed among the nation's best teaching hospitals; EMH Regional Medical Center in Elyria was listed as a best large community hospital; best medium community hospitals included Mercy Hospital Anderson in Cincinnati, Wooster Community Hospital in Wooster, Licking Memorial Hospital in Newark, and Kettering Medical Center-Sycamore in Miamisburg.

Feds add patient ratings to Hospital Compare website

The Federal government has now placed patient ratings of hospitals on a publicly available government website. (Source: "Site shows how patients in U.S. rate hospitals," Columbus Dispatch, March 29, 2008.) The website, Hospital Compare, gives patient ratings of more than 2,500 hospitals on such topics as cleanliness, quietness and communication with doctors and nurses. "Leaders of hospital and labor groups heralded the addition of patient-satisfaction information, saying it empowers patients and doctors and gives hospital executives guidance on how to improve. Most measures focus on things hospital workers do for patients, such as giving aspirin to heart patients. Two measures look at outcomes, data many view as the most significant step to demystify the quality of health care. More outcomes data, including mortality numbers, are expected as more transparency is required." According to Carolyn Clancy, director of the federal Agency for Healthcare Research and Quality, 61% of patients go to hospitals for elective procedures, meaning websites like this one will be useful since most patients have the opportunity to consider where they'll be treated.

Board of Nursing to use online system for LPN license renewals

Starting this year, the Ohio Board of Nursing will utilize an online system for licensed practice nurse (LPN) renewals. All LPNs who are eligible to renew their licenses during 2008 will receive notification by mail in April along with instructions on how to renew their licenses online. LPNs can also verify the renewal of a license through the website. For more information or to renew a license, go here.

Website features comparison data on Cincinnati hospitals

"A new Web site allows users to find out how individual Greater Cincinnati hospitals compare on performance measures related to heart attack, congestive heart failure and pneumonia." (Source: "Web site allows Cincinnati hospital comparisons," Business Courier of Cincinnati, Feb. 27, 2008.) The website's data was collected is part through the Hospital Quality Improvement Project initiative of the Greater Cincinnati Health Council and the Ohio Hospital Association. While hospitals were not required to participate in the effort, at least 20 of them did. To access the website, go to www.gchchospitalquality.org.

Ohio hospitals, emergency rooms see large increase in visits

According to new information from the Ohio Hospital Association (OHA), there were more than 34 million inpatient and outpatient visits to Ohio hospitals in 2006, an increase of nearly 13% in the past five years. (Source: "Different Hospitals, Different Doorways, Constant Care," Health Beat, Feb. 28, 2008, Ohio Hospital Association.) Outpatient visits drove the increase, but 1.5 million visits were serious enough to require hospital admission (with Ohioans receiving inpatient hospital care for a total of 7.7 million days).

Hospital emergency departments are also saw an sharp increase in patients with 5.7 million visits in 2006. This represents a 13.6% increase over 2003. Of these visit to the emergency rooms in 2006, 933,000 were from patients without insurance coverage--even though only 8% of these uninsured patients had a serious enough medical condition to require an observation bed or admittance to the hospital. According to the OHA, this shows that hospital emergency departments are being used as a major source of general health care services for Ohio's uninsured, who have limited access to other sources of health care.

Questions raised about visa program for primary care physicians

In a parallel to last week's report about the shortage of physicians in the Greater Cincinnati area (and, by extension, in most of Ohio), The Plain Dealer has examined a program allowing foreign-born medical grads to be primary care doctors in this state. (Source: "Visa program not helping ease Ohio's primary care doctors shortage," Feb. 17, 2008.) Under the J-1 visa waiver program, foreign physicians are granted visas to come to the United States and practice in inner-city and rural areas that need them. However, the article details how "big hospitals like the Cleveland Clinic" are also using the program to keep specialists on their staffs.

Eileen Sheil, spokeswoman for the Cleveland Clinic, says the program is vital because her hospital can't find enough American doctors who are specialists, and that these specialists do indeed serve the underserved. However, Joe Liszak, chief executive of Fremont-based Community Health Services, a federally qualified health center in Sandusky County, wonders why multimillion-dollar hospital organizations are using this visa program when organizations like his own have such a hard time finding doctors.

State to close two mental hospitals, lay off employees to cover budget shortfall

Governor Strickland said the state plans to close two mental hospitals and layoff state employees to plug a projected budget shortfall over the next 17 months. (Source: "Ax taken to state jobs," Columbus Dispatch, Feb. 1, 2008.) The closings and layoffs are expected to save the state $733 million, with the state's budget shortfall expected to range from $733 million to $1.9 billion by July 2009. If the worst budget projects come true, the state will tap a $1 billion rainy day fund to cover the difference.

James Ignelzi, deputy director of the Department of Mental Health, said closing the out of date 48-bed Cambridge hospital, part of Appalachian Behavioral Health, will lead to the loss of 130 jobs and a $5.8 million payroll. Some of those beds will be transfered to Athens' mental hospital, which will double from 40 beds to 80. In addition, the 110-bed hospital of Twin Valley Behavioral Healthcare with a staff of 200 will close. Ignelzi said many of those patients and some of the jobs will move to Columbus.

John Martin, director of the MRDD Department, said his agency will lose as many as "380 employees, including 45 in the central office in Columbus. An estimated 165 to 170 patients at state developmental centers will be released on waivers, allowing them to obtain the same services at local facilities or at home. The Department of Job and Family Services, which oversees Medicaid, food stamps and other programs for the poor, must cut up to 12% of its staff of 4,000."

Attorney General wants poor, uninsured to pay same medical prices as insurance companies

Ohio Attorney General Marc Dann "wants to ensure that the state's poor and uninsured pay the same prices for medical care as insurance companies." (Source: "Ohio attorney general wants poor to pay same for medical care as insurance companies," Plain Dealer, Jan. 30, 2008.) Dann said he is concerned about uninsured patients paying higher prices for medical procedures than insurance companies because they don't get large negotiated discounts. The proposal is part of Dann's new push to define what non-profit hospitals must do for their communities to remain tax exempt. Dann also says "he will hire experts to help define charity care" with regards to non-profit hospitals. The Ohio Hospital Association (OHA) says they plan to work with Dann to come up with these standards, with OHA spokeswoman Tiffany Himmelreich saying Dann should also consider other community benefits provided by hospitals, such as medical research and job creation.

Hospital association, attorney general's office debate Medicaid false claim bill

"The Ohio Hospital Association urged rejection Wednesday of a House proposal to let individuals file lawsuits on the state’s behalf over alleged Medicaid fraud, predicting it would generate frivolous actions from whistleblowers." (Source: Gongwer Report, Jan. 23, 2008.) However, John Guthrie, chief of the health care fraud section in the Ohio attorney general's office, called the measure "an effective complement to the federal False Claims Act that would enable the state of Ohio to successfully combat fraud." House Bill 355 is sponsored by Rep. Jim Hughes (R-Columbus) and would allow individuals to file civil suits against persons or institutions that are "knowingly and deliberately" defrauding the state of money.