Understanding Hospital Accountability

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We often simply think of hospitals as massive organizations that provide one-way healthcare to a guaranteed patient base. But customer care is also customer service. Even the largest and most public hospitals depend on their patients for good review numbers and a positive image. And smaller private clinics rely even more heavily on their patients to raise funds and spread the word about their services.

No matter which clinic or hospital you visit, remember that you always have the most powerful say in your own healthcare. No medical professional should ever make you feel too overwhelmed to take control of your treatment. It’s your right to hold clinicians accountable for the quality of the information and service they provide you.

Common Hospital Concerns

There are many complaints waged against hospital care. Below is a list of issues that U.S. patients most commonly file formal complaints against. All are areas where medical professionals are legally bound to provide the best possible care. Acquaint yourself with a hospital’s care record on each of these issues before making it your first-choice facility.

General Care Quality: Inattention, arrogance, and poor service are among the most frequent accusations U.S. patients bring against their hospital doctors. Of course, these intangible personality problems are among the hardest problems for hospitals to address. Ask yourself if condescension would be a major problem for you and then read reviews to get a feel for the kind of care you’ll encounter at a certain hospital.

Nonprofit Programs: Unfortunately, qualifying as low-income in these programs can be a pain. Requirements are difficult to understand, the forms are confusing to fill out, and bills can be slow coming. As a result, patients of non-profit organizations often complain of inefficient, drawn out processing and minimal, low-budget care. (The reason for this? To maintain funding and non-profit status, clinics must maintain a certain ratio of uninsured patients to insured patients. Unfortunately, these facilities really do need all of this paperwork to continue to serve patients whose incomes bar them from traditional medical care.)

Hospital Infections: Hospital-acquired infections are growing problem in American hospitals. By 2010 around 100,000 people were dying of healthcare infections every year. Hospitals are obviously full of sick people – germs spread easily. Unfortunately, few hospitals have the resources to heavily audit hygiene procedures more than once a year. Research your hospital’s history of staph infections and check for patient complaints of hospitals using dated hygiene guidelines.

Hospital Superbugs: The evolution of super-bacteria in clinics worldwide is one of the biggest problems facing large, busy hospitals today. Antibacterial agents kill weaker bacteria, but stronger types can survive. Those that do eventually produce harmful strains resistant to existing antibiotics. These superbugs are particularly dangerous for hospital patients whose immune systems are already weakened. Hospitals are prime breeding zones for this bacteria, but few are changing the way they use antibacterial agents.

Health Coding: Many U.S. hospitals are overdue for a switch to ICD-10 codes. Why are they late? Updating health codes requires massive time and money investments from all hospitals. Hospitals that successfully make the switch should have better information systems, more accurate billing, and more efficient communication procedures. But patients may notice care suffers during these transitions.

High Costs: High costs are a common complaint by patients. Private patients typically face the highest expenses with no way of knowing how fair their bills are.

Bill Mistakes: Following closely behind high costs are bill mistakes, where items are charged twice or extra services are incorrectly added, raising the total expense. Patients need to read lengthy bills carefully to be certain that there are no  mistakes or double charges.

Data Security: HIPAA laws protect your personal health information. However, hospitals do not always follow HIPAA. As technology use increases, a large amount of “protected” information has found its way to unsecured laptops, portable devices, and other systems. These serious security breaches has led to steep fines for some, such as Cignet Health of Maryland.

Choosing a Hospital: Vital Data

Following Standards: Hospitals have hundreds of guidelines to follow regarding everything from accident prevention and chemical safety to contamination control plans. Audits frequently uncover organizations that fall short. Ask hospitals to show you the results of their latest state health audit – or call your state department of labor or health department to see what information you can obtain. There are also a number of private organizations that track and rate hospitals in the United States.

Per Capita Costs: Ask for the per capita Medicare costs. Request the net patient revenue or per equivalent discharge numbers. Look at the overall hospital cost composition. If you learn to read these documents, you can see where a hospital spends its money and how its costs compare to other options. The Hospital Cost Index is a valuable tool for this research.

Ask for a Tour: Use the opportunity to ask about specific standards, sanitation checklists to reduce acquired infections, and any other resources the hospital can give you. Ask pointed questions about costs or charges based on treatment options.

History of Lawsuits or Fines: Search state records or other public sources of information for information on lawsuits or fines directed at a particular hospital. Has the hospital taken steps to change its system and prevent future problems in the same area?

Make Your Health Your Own

Do not let hospitals dictate your health decisions! Use all the information you can find to make your own choices whenever possible. Here is a collection of links to search more deeply into hospital data:

Becker’s Hospital Review: 80 Accountable Care Organizations to Know

Patient Safety Partnership: Choosing a Hospital

Consumer’s Checkbook: Advice and Explanations