Probably the most controversial thing I've ever written is that the evidence for the effect of health insurance on mortality is not really that strong. This is not to say that insurance has no effect--this is possible, but not to my mind particularly likely. But studies purporting to show big impacts are vulnerable to what economists call "unobserved variable bias": because we can't really do massive controlled social experiments on human beings, people who lack health insurance are not exactly like people who have health insurance, except for their health insurance status; they have a bunch of other things going on in their lives that make them less likely to be insured, and which may also affect their health. (Examples of things that are hard to control for well: they have poor quality social and family networks, have major impulse control problems, have a drinking or drug problem, did not have good parenting, or were born in another, poorer country where they were exposed to disease pathogens and poor nutrition that do not affect American children).
Massachusetts teaching hospitals would lose $322 million, or about two-thirds of the federal dollars they receive for the training of medical residents, under a bipartisan proposal to tamp down the rising costs of Medicare and reduce the federal deficit. The proposal, a slice of at least $1.6 trillion in spending cuts over the next decade being considered as negotiators try to forge a broad agreement to raise the nation's debt limit, could be a body-blow to the region's health care industry, a key part of the overall economy, analysts said. It also promises to intensify the debate over the role of hospitals and the best way to deliver high-quality services to patients in a cost-effective manner.
In Louisiana, The University Medical Center governing board has abandoned its effort to secure federal mortgage financing to back any debt necessary to complete a new teaching hospital near downtown, and a UMC consultant said the project could be headed for further changes that he did not detail. The financing decision, documented today in a letter from a Jay Shah of J.P. Morgan to a top bureaucrat at the U.S. Department of Housing and Urban Development, comes as the hospital governing board considers a final business plan, design and financing scheme for what has been projected as a $1.2 billion, 424-bed complex. The UMC board is scheduled to meet next Wednesday. Chairman Bobby Yarborough has promised a completed business plan and financing arrangement by September.
Dr. David Smith, president of Upstate Medical University, handed out coffee mugs to his senior management team last fall. The cups were inscribed with the expression, "Get-r-done!" referring to Upstate's effort to buy Community General Hospital. Smith and other hospital officials celebrated the fulfillment of that motto today at a ceremony in front of Community General Hospital. "This is a game-changing event for us," Smith said. "This is not just about having two hospitals coming together, but a university coming together." Smith said the acquisition of Community General will give Upstate a larger platform to care for patients, teach medical students and other health professionals and do research.
Are the best hospitals run by medical doctors or business managers? The conventional wisdom is that doctors should focus on patient care, and managers with a business or administrative background are better suited to running the day-to-day operations of a hospital. Among the nearly 6,500 hospitals in the United States, only 235 are run by physician administrators, according to a 2009 study in the journal Academic Medicine. But now new research suggests that having a doctor in charge at the top is connected to overall better patient care and a better hospital. The findings, published in the journal Social Science & Medicine, are based on a review of 300 top-ranked American hospitals in the specialties of cancer, digestive disorders and heart surgery.
A new charter high school designed to train nurses is expected to win final approval from the state Board of Regents for Elementary and Secondary Education Thursday afternoon. The school, which would be public and paid for by taxpayers, is scheduled to open in downtown Providence in September, starting with 136 10th and 11th graders.Supporters of the Rhode Island Nurses Institute Middle College say the school will serve a dual purpose: help the state address a growing nurse shortage and provide a high-quality education to hundreds of students, many of whom come from low-income families and are stuck in low-performing schools. Students from across the state can apply. The first year's class is already full and there is a wait list of more than 20 students, say the school's sponsors.