[EQ] The Cost of Hospital Stays: Why Costs Vary

The Cost of Hospital Stays: Why Costs Vary

 

Canadian Institute for Health Information (CIHI) 2008

 

Available online PDF file [73p.] at: http://secure.cihi.ca/cihiweb/products/2008HospCosts_report_final_Eng_web.pdf

 

“… This looks at the average costs of a wide range of treatments and procedures performed during acute care hospital stays for typical patients, and some of the reasons these costs can vary from patient to patient.

 

The report begins by providing the big picture on how much Canada spends on hospitals and in relation to total health expenditures. It then shows how new tools such as CMG+ can be used to estimate costs of hospital stays. Finally, the report provides insights on how certain factors can affect hospitalization costs for typical cases, such as the presence of other illnesses (beyond the most responsible reason for admission into hospital), the age of a patient, how many interventions are used during a patient's hospital stay, how and where a patient is treated and the type of interventions used….”

 

What Is and Case Mix Groups CMG+?

The CMG+ methodology is used to create distinct patient groupings that are clinically similar and/or homogenous with respect to hospital resources used. By linking patient groups to resources used in their treatment, CMG+ provides a tool for analyzing resource utilization and costs.

The case mix grouping methodology was revised to make use of the most recent Canadian classification systems for diseases and related health problems and interventions.

The CMG+ methodology assigns patient records to major clinical categories (MCCs) and Case Mix Groups (CMGs). Both MCCs and CMGs are based on either a diagnosis or condition described as being most responsible for the patient’s stay in hospital—in clinical terms, the “most responsible diagnosis” (MRDx)—or based on an intervention that significantly affects the pattern of care and resources consumed by a patient.

 

Content:

Executive Summary

1. Overview of Hospital Spending in Canada

Who Pays for Hospital Care?

Where Does the Money Go?

Breaking Down Hospital Spending

2. Measuring Average Acute In-Hospital Costs

What Is CMG+?

What’s New About CMG+: The Five Factors

Using CMG+ and Other Tools to Calculate Average Costs

3. Looking Into Hospital Costs: Selected Examples

Factors Affecting Hospital Costs

Cost of Treating Atypical and Long-Stay Patients

Information Gaps

What We Know

What We Don’t Know

What’s Happening

References

Appendix

 

 

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[EQ] US National Healthcare Disparities Report - 2007

National Healthcare Disparities Report, 2007   U.S. Department of Health and Human Services Agency for Healthcare Research and Quality Rockville, MD - AHRQ Publication No. 08-0040 - February 2008

Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. The reports present, in chart form, the latest available findings on quality of and access to health care. The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as children and older adults. National Healthcare Disparities Report Available online PDF file [252p.] at: http://www.ahrq.gov/qual/nhdr07/nhdr07.pdf National Healthcare Quality Report (NHQR) Full report available online as PDF file [144p.] at: http://www.ahrq.gov/qual/nhqr07/nhqr07.pdf   Highlights 1. Introduction and Methods 2. Effectiveness. Cancer . Diabetes End Stage Renal Disease (ESRD) Heart Disease HIV and AIDS . Maternal and Child Health Mental Health and Substance Abuse . Respiratory Diseases. Nursing Home, Home Health, and Hospice Care.   3. Patient Safety 4. Timeliness 5. Patient Centeredness 6. Efficiency     Website: http://www.ahrq.gov/qual/qrdr07.htm

 

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[EQ] Measuring Financial Protection in Health

Measuring Financial Protection in Health

Adam Wagstaff

The World Bank - Development Research Group - Human Development and Public Services Team

March 2008 - Policy Research Working Paper 4554

 

Available online as PDF file [34p.] at:
http://www-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2008/03/12/000158349_20080312140044/Rendered/PDF/wps4554.pdf

 

“…..Health systems are not just about improving health. Good ones also ensure that people are protected from the financial consequences of illness and death, or at least from the financial consequences associated with the use of medical care. Anecdotal evidence suggests health systems often perform badly in this respect, apparently with devastating consequences for households, especially poor ones and near-poor ones. The World Bank’s 50-country participatory poverty study known as Voices of the Poor1 found that poor health and illness are universally dreaded as a source of destitution, partly because of the costs of health care but also the income lost due to illness.

 

Voices of the Poor documents the case of a 26 year-old Vietnamese man who, as a result of the large health care costs necessitated by his daughter’s severe illness, has moved from being the richest man in his community to being one of the poorest.2 Also recorded was the case of a 30-year-old Indian mother of four who has been forced to sell the family’s home and land, and has to walk 10 kilometers a day transporting wood on her head in order to finance the cost of her diabetic husband’s medical care.2

 

How can one measure the success with which a health system protects people against the financial consequences of ill health? What do systems that do well in this regard have in common? And how far do health system reforms improve people’s financial protection vis-à-vis health expenses?

 

This paper provides an overview of the methods and issues arising in each case, and presents empirical work in the area of financial protection in health, including the impacts of government policy. The paper also eviews a recent critique of the methods used to measure financial protection…….”

 

 

 

 

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[EQ] Debate: Recognizing the achievements, addressing the challenges and getting back on track to achieve the MDGs

Debate:
Recognizing the achievements, addressing the challenges and getting back on track to achieve the MDGs by 2015

 

UN General Assembly to Seek Urgent Action on Poverty, Education and Health to Achieve Millennium Development Goals

1-2 April 2008

 

Website: http://www.un.org/ga/president/62/ThematicDebates/mdgthematicdebate.shtml

 

“….will concentrate on the eradication of extreme poverty and hunger, achieving universal primary education, reducing child mortality, improving maternal health, and combating malaria and other diseases….”

 

UN General Assembly debate will bring together representatives from academia, business, government, nongovernmental organizations and the UN System.

 

The event will be webcast live at www.un.org/webcast

 

       Documents:

       Backgrounder - "Poverty and Hunger"

       Backgrounder - "Education"

       Backgrounder - "Health"

 

More information: www.un.org/millenniumgoals

 

 

 

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[EQ] UCL Summer School: Social Determinants of Health - International health

 

Social Determinants of Health – International Health

 

Health and Society UCL Summer School, 30 June – 4 July 2008

University College London

 

Website: www.ucl.ac.uk/healthandsociety

 

Brochure:  http://www.ucl.ac.uk/healthandsociety/myimages/Summer%20School%2007%20flyer.pdf

 

The Social Determinants of Health course will cover: Class, Work, Gender, Ethnicity, Area effects and health, Life course approach to social epidemiology,

The Russian mortality crisis, and Social biological translation.

 

The International Health Option will cover: Global health patterns, International socio-economic development, International and in-country health inequality (child mortality), Globalization and health, Architecture of international health, Governance and health, Health systems and Fragile states: state breakdown, conflict and displacement.

 

Joint sessions: Professor Sir Michael Marmot will open the summer school with a presentation on the Social determinants of health and close the week with a

lecture and discussion on National – since the Black Report – and international policy development.

 

Professor Richard Wilkinson will give a guest lecture on Relative deprivation and income inequality.

A public lecture will also be hosted during the summer school on the topic ‘Obesity – What hope for change?’ speakers include Professors Tim Lang, City University, Jane Wardle, UCL, Martin McKee, LSHTM and Phil James, International Obesity Task Force (tbc). The public lecture will be chaired by Dr Eric Brunner.

.

Directors and teaching staff:

Professor Mel Bartley, Dr Martin Bobak,

Dr Eric Brunner (Course director),

Dr Tarani Chandola, Dr Sharon Friel,

Dr Tanja Houweling, Professor Diana

Kuh, Dr Hynek Pikhart (Course director),

Dr Mai Stafford and Dr Sebastian Taylor.

 

Contact Catherine Conroy (course administrator). T: +44 (0)20 7679 1680 E: graduateinfo@public-health.ucl.ac.uk

 

 

 

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[EQ] National Public Health Institutes: Contributing to the Public Good

National Public Health Institutes: Contributing to the Public Good

 

Sue Binder1, Lola Adigun1, Courtenay Dusenbury1, Allison Greenspan1 and Paula Tanhuanpää2
1International Association of National Public Health Institutes (IANPHI) Sub-Secretariat, Atlanta, GA, USA

2IANPHI Secretariat, KTL, Helsinki, Finland

Journal of Public Health Policy  - April 2008 - 29, 3–21. doi:10.1057/palgrave.jphp.3200167

 

Website: http://www.palgrave-journals.com/jphp/journal/v29/n1/full/3200167a.html

 

“……..Donor and government funding for public health programs in low-resource countries – to increase immunizations or treat HIV/AIDS, for example – has risen dramatically. Rising less rapidly is the funding for public health functions that are not direct services or linked to programs for high-priority diseases and conditions. In many countries, these functions are housed in National Public Health Institutes (NPHIs). NPHIs are science-based agencies, usually within national governments, that include in their missions such public goods as assessing and monitoring the population's health and responding to outbreaks. Through a survey, we collected information from and about members of a new international organization for NPHIs. The responses illustrate the roles of NPHIs as purveyors of public goods. Data collected in the future on NPHI structures, practices, and challenges will be helpful to countries that are creating or restructuring NPHIs. The new knowledge will also help advocates for increasing budgetary support for the public goods functions of NPHIs……”

 

“…….National Public Health Institutes (NPHIs) are science-based agencies, usually within national governments, whose missions include such public goods as assessing and monitoring the population's health and responding to outbreaks. This paper describes the importance of NPHIs in the context of growing concern about and investment in global public health and includes the results of a systematic effort to capture data about the range of NPHI infrastructure and activities…..”

 

Editorial

Journal of Public Health Policy (2008) 29, 1–2. doi:10.1057/palgrave.jphp.3200171

National Public Health Institutes

http://www.palgrave-journals.com/jphp/journal/v29/n1/full/3200171a.html

 

NPHIs and Public Goods: A Perspective from Morocco

The Director of the Institute Pasteur of Morocco explains that consolidation of public health functions into a single agency would encourage a comprehensive approach to public health in Morocco.

Mohammed Hassar

J Public Health Pol 29: 22-25; doi:10.1057/palgrave.jphp.3200166

Abstract | Full Text | PDF

A Perspective from Mexico 

The Director General of the Mexico's National Institute of Public Health describes his institute, one of the oldest and most extensive in the world.

Mario Henry Rodríguez- López

J Public Health Pol 29: 26-31; doi:10.1057/palgrave.jphp.3200168

Abstract | Full Text | PDF

 

TABLE OF CONTENTS

April 2008, Volume 29, Number 1

 

This issue now available at: www.palgrave-journals.com/jphp/journal/v29/n1/index.html

A Roundtable Discussion Begins: National Public Health Institutes–and new Collaboration among them worldwide

Special Section: Health and Human Rights: Critical Historical Perspectives from the Cold War to the New World Order

 

 

 

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[EQ] Common Wealth - Economics for a Crowded Planet

Common Wealth    - Economics for a Crowded Planet

Jeffrey D. Sachs – ISBN 9781594201271 - 18 Mar 2008 - The Penguin Press

   

Common Wealth Forum: http://www.sachs.earth.columbia.edu/commonwealth/reviews.php

 

"……The global economic system now faces a sustainability crisis, Jeffrey Sachs argues, that will overturn many of our basic assumptions about economic life. The changes will be deeper than a rebalancing of economics and politics among different parts of the world; the very idea of competing nation-states scrambling for power, resources, and markets will, in some crucial respects, become passŽ. The only question is how bad it will have to get before we face the unavoidable. We will have to learn on a global scale some of the hard lessons that successful societies have gradually and grudgingly learned within national borders: that there must be common ground between rich and poor, among competing ethnic groups, and between society and nature.

 

The central theme of Jeffrey Sachs's new book is that we need a new economic paradigm-global, inclusive, cooperative, environmentally aware, science based-because we are running up against the realities of a crowded planet. The alternative is a worldwide economic collapse of unprecedented severity. Prosperity will have to be sustained through more cooperative processes, relying as much on public policy as on market forces to spread technology, address the needs of the poor, and to husband threatened resources of water, air, energy, land, and biodiversity.

The "soft issues" of the environment, public health, and population will become the hard issues of geopolitics. New forms of global politics will in important ways replace capital-city-dominated national diplomacy and intrigue. National governments, even the United States, will become much weaker actors as scientific networks and socially responsible investors and foundations become the more powerful actors.

 

If we do the right things, there is room for all on the planet. We can achieve the four key goals of a global society: prosperity for all, the end of extreme poverty, stabilization of the global population, and environmental sustainability. These are not utopian goals or pipe dreams, yet they are far from automatic. Indeed, we are not on a successful trajectory now to achieve these goals. Common Wealth points the way to the course correction we must embrace for the sake of our common future…."

 

 

Conference: State of the Planet 08

March 27-28, 2008

 

Website: http://www.earth.columbia.edu/sop2008/

The Earth Institute -  Columbia University

Registration to watch live online: http://www.earth.columbia.edu/sop2008/

 

Agenda Thursday, March 27, 2008
9:30 a.m.	Welcome: John C. Mutter, State of the Planet Steering Committee
9:45 a.m.	Opening Remarks Lee C. Bollinger, Columbia University
10:00 a.m.	Keynote Kofi A. Annan, Former Secretary-General of the United Nations President, Global Humanitarian Forum
10:20 a.m.	Session 1: Eradicating Poverty as the Poor Population Expands Moderator: Matthew Bishop, The Economist
	Session Keynote Asha-Rose Migiro, Deputy Secretary-General of the United Nations
	Panel Gregory Clark, University of California-Davis John McArthur, The Earth Institute at Columbia University Erik S. Reinert, The Other Canon Foundation, Norway Carl-Henric Svanberg, President and CEO, Telefonaktiebolaget LM Ericsson Laurence Tubiana, Sciences Po Paris
1:45 p.m.	Global Health and the Foreign Policy Agenda Jonas Gahr Støre, Minister of Foreign Affairs, Norway
2:15 p.m.	Session 2: Addressing Areas of Conflict in Our Changing World Moderator: Jonathan Ledgard, The Economist
	Session Keynote Jan Egeland, Norwegian Institute of International Affairs Panel Kathryn McPhail, International Council on Mining & Metals (ICMM) Andrew Morton, United Nations Environment Programme Jill Shankleman, J. Shankleman Limited David Victor, Stanford University
4:15 p.m.	Improving Health for Sustainable Development Alice Dautry, President, Institut Pasteur
4:45 p.m.	Closing Remarks
	Jeffrey D. Sachs, The Earth Institute at Columbia University
6:30 p.m.	Special Evening Event
	The Economist Debates: The United States and Climate Change Proposition: "The United States  will solve the climate change problem."
	Host: Vijay V. Vaitheeswaran, The Economist
Friday, March 28, 2008
9:30 a.m.	Special Lecture: The Challenge of Sustainable Development in the Next Administration Jeffrey D. Sachs
10:00 a.m.	Keynote Barbara Thomas Judge, Chairman, UK Atomic Energy Authority
10:30 a.m.	Session 3: Identifying Energy Solutions for Sustainable Development Sponsored by the    Columbia Business School Energy Club and    School of International and Public Affairs Energy Association Moderator: Edward Mcbride, The Economist
	Session Keynote
	Paula DiPerna, Chicago Climate Exchange
	Panel
	Eron Bloomgarden, EcoSecurities
	Michael Grubb, UK Carbon Trust
	Klaus S. Lackner, The Earth Institute at Columbia University
	Roberto Rodrigues, Superior Agriculture Council of São Paulo's Federation of Industries
2:00 p.m.	Session 4: Responding to Accelerated Environmental Change in the Arctic Sponsored by the    Royal Norwegian Consulate General Moderator: Geoffrey Carr, The Economist
	Panel
	Ken Drinkwater, University of Bergen, Norway
	Grete K. Hovelsrud, Center for International Climate and Environmental Research
	Eystein Jansen, University of Bergen, Norway
	Peter Schlosser, The Earth Institute at Columbia University
	Daniel M. White, Institute of Northern Engineering
4:10 p.m.	Closing Remarks: Jeffrey D. Sachs

 

 

 

 

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