In a letter to affiliated physicians and staff, Hoag Hospital in Newport Beach has announced that elective abortions will no longer be performed at the hospital.

The letter said the decision is based of the low number of procedures done annually at the hospital and was made following a review of clinical services performed at the facility.

Hoag Chief Executive and President Robert Braithwaite said there is a direct correlation between quality of care and the number of procedures performed. Elective abortions, he said, are seldom performed in hospitals, partly because of the expense and the less private or intimate setting.

Hoag provided about 100 abortions a year, compared with 6,000 births and 10,000 mammograms, Braithwaite said.

“The bottom line is to provide high-quality healthcare to this community,” he said.

The decision does not affect the dispensing of emergency contraception following rape or sexual assault, emergency services for women who experience complications from pregnancy termination at other facilities, or management of ectopic or other pregnancy complications, according to the letter sent out to physicians dated May 1.

The review of services was prompted by the hospital’s partnership with St. Joseph Health, a Roman Catholic-affiliated institution, although Braithwaite said at no point did St. Joseph pressure the board to change its policy on elective abortions.

Braithwaite cited other procedures still performed at Hoag, including tubal ligation, which are typically not provided by Catholic healthcare providers.

Hospital officials emphasized that patient-physician relationships wouldn’t change and that Hoag-affiliated doctors could still perform abortions, just not at Hoag.

Physicians had mixed reactions to the announcement, according to Dr. Allyson Brooks, the executive medical director for Hoag’s Women’s Health Institute.

“We consider ourselves a center of excellence … and have provided great care, so it’s not unusual for our OB/GYN staff to feel like something went away,” Brooks said.

She said that on an individual basis, many physicians understood the change because so few elective abortions were performed at Hoag. Some doctors were worried that other factors played a part in the decision, Brooks said, but she denied this.

Brooks said there would not be a lack of access to the service since there are many other nearby academic and outpatient centers where elective abortions are performed, including UC Irvine, Planned Parenthood and Family Planning Associates Medical Group.

The elimination of elective abortions isn’t the first time the hospital has gotten rid of a program, Braithwaite said. About five years ago, the hospital decided to eliminate in-patient pediatric care because it felt those patients were best served by the Children’s Hospital of Orange County.

Source: latimes.com

As provincial government revenues stagnate with the sluggish economy, provinces are turning their eye to hospitals as a very obvious target for reductions in spending growth. Provinces spend more than $60 billion a year on hospitals — about $2.5 billion in Manitoba — which is more than they spend on many of their entire ministries.

Right now, most of this money flows to hospitals with few strings attached. Changes are underway to hospital funding pathways, however, to try and ensure that we get good value for that money.

The most recent data from the Canadian Institute for Health Information points to marked variation between hospitals in what this money buys. For example, a hospitalization for a hip replacement in one hospital can cost in excess of 50 per cent more than other hospitals in the same province.

The public should care about this, since large differences in spending between hospitals for the same type of care imply that there is potential for governments to cut spending. If hospital A can do hip replacements for $5,000 per patient why are we paying hospital B $8,000 per patient? If governments can find ways to bring hospital B’s costs closer to $5,000 the hospital has become more efficient and government spends less.

Every year provinces give hospitals a fixed percentage increase to their budget from the previous year. This across-the-board increase, similar to a cost-of-living increase, is intended to reflect increasing input costs, such as wage increases and new technologies and drugs. Over the past half-decade, these annual increases have been in the neighborhood of five per cent.

This type of budgeting and incentive structure rewards all hospitals with new funding equally. Perpetuating across-the-board increases provides little motivation for inefficient hospitals to change the way they operate.

Ontario and British Columbia are starting to change the way they fund hospitals. For the past few years, both provinces have directed hundreds of millions of dollars to hospitals as an incentive to perform more surgeries by tying funding to a fixed price per surgery. Hospitals that can perform surgeries at or below that price will generate free cash flow. Hospitals whose costs per surgery are higher quickly realize that they are receiving smaller increases than their more cost-efficient peers.

Some hospitals can’t compete on cost-efficiency alone. Hospital spending data shows that it costs more to operate hospitals in small and isolated communities than in urban centres.

Ontario and British Columbia are hoping their new hospital funding initiatives won’t close hospitals or undermine quality, but will instead put financial pressure on inefficient hospitals to change their management practices.

It’s not all about saving money.

Every opportunity to improve the safety and quality of hospital care should be seized. Government regulations can be vigilantly monitored to ensure hospitals are meeting acceptable standards of safety. Meeting such standards could also be tied to new hospital funding.

Another idea is to measure quality from the perspective of the patient. The experiences of patients at the hospital and changes in their quality-of-life after surgery should be tracked. Too often, provinces are choosing hip and knee replacements without considering other surgeries and procedures.

The value we get for the money we spend on hospital care can be improved by changing the way we spend that money. Perpetually distributing lump sums to hospitals with few strings attached can no longer be excused in the current economic climate. While change won’t be easy, it’s good that Ontario and British Columbia are leading the way. Other provinces will follow.

Jason M. Sutherland is an expert adviser with EvidenceNetwork.ca and assistant professor at the centre for health services and policy research, University of British Columbia. Nadya Repin is a research coordinator with the centre for health services and policy research, UBC. Their C.D. Howe Institute publication, Paying for Hospital Services: A Hard Look at the Options can be found at www.cdhowe.org

Source: winnipegfreepress.com

The Bermuda Hospitals Board today announced that it will be ceasing to provide a day care service for seniors from its Continuing Care Unit from 28 June 2013.

Clients and their families have been informed and directed to other organizations that provide a similar day time service in the community. The service is separate to the CCU residential service in CCU Lower, CCU Upper and the Alzheimer’s Related Disorder Unit [ARDU], which has over 100 beds and will continue operating as usual.

The day care service was for seniors who lived outside of CCU and provided supervision, recreation/socialization, meals and medication delivery on week days.

BHB had provided this service from the Continuing Care Unit for over twenty years, but the number of visits had decreased in recent times. The average monthly number of visits per client had dropped 50% from 15 to 8 from fiscal year 2008/9 to 2012/13. This resulted in about 6 to 8 clients using the service each day last year. The service costs $270,000 per year to run, BHB said.

Granville Russell, Director of the Continuing Care Unit comments: “We are sorry to say goodbye to our day care clients, but with reduced client visits, the retirement of two key members of staff and increasing space pressures within the CCU facility, it was time to review the viability of this service.

“We felt this was not a core BHB service and similar services are already provided by others in the community at a fair price. For the numbers concerned, BHB could not maintain this service at a viable price in order to cover its costs. I would like to thank our retiring staff and the drivers who provided a wonderful day time service and recognize their hard work in catering for this group.”

The service employed one registered nurse, an activity aide and two part-time drivers. The staff members in the nurse and activity aide positions are retiring. The drivers already had other duties within CCU and will remain with BHB.

Venetta Symonds, CEO & President adds: “BHB is about to go through an intensive process of service review and reshaping that will take about 4 to 6 months. The retirement of key staff in this service meant a decision on this service had to made ahead of the full review, but a full business case with multiple options was considered by the Senior Management Team.

“We will be asking the same questions about all our services – should BHB be providing it, or is it better provided by others, whether Government or the private sector. The pressure is there for BHB to focus on its core services and ensure they are provided at the highest quality and at best value.

“The strategic planning process will require collaboration and cooperation across the healthcare continuum, which is a positive development for Bermuda. While I anticipate some reshaping of BHB services after this process, it will be coordinated sensitively to ensure minimal disruptions for our clients, patients and staff.”

Source: bernews.com

At the special meeting of the Mineral County Commissioners on April 23, Denyse Traeder of the Mineral Community Hospital made a presentation on the hospital’s Frontier Medicine Better Health Partnership. According to Traeder, the partnership was formed by MCH as a response to the changing nature of health care in the country.

“The Innovations Program (another name for the Frontier Medicine Better Health Partnership) was formed by the legislature to look at new and innovative ways to look at health care,” Traeder said.

According to Traeder, employees at the hospital wrote in “many cool things” in the grant and the hospital won the nationwide grant out of over 9,000 hospitals that applied.

“Health care as we know it isn’t sustainable,” Traeder said. “If health care had risen by the same percentage as food we would be paying $108 for a pound of oranges. So we know that it’s outrageous and if this was happening with food there would be a huge outcry. But because we all need healthcare we aren’t really seeing as much of a pushback so we are here trying to tackle some of these issues.”

The Frontier Medicine Better Health Partnership was created for Critical Access Hospitals, hospitals with less than 25 beds, as a response to the changing nature of health care in the nation.

“It’s a grass root effort created by critical access hospitals for critical access hospitals,” Traeder said.

Traeder added that the partnership was created to “give small, critical access hospitals a voice” by teaming them all together and creating a nationwide partnership.

“We have been funded for three years and we have the possibility of continuing for seven years if we show the cost-cutting we think we can show,” Traeder said.

Twenty-five hospitals in the state have already teamed up with MCH in the partnership and according to Traeder the number will only increase with time.

“We believe that we will have closer to all 48 (critical access hospitals in Montana) join,” Traeder said. “They are very excited about this because it gives them quite a bit to work with within their communities.”

Traeder, who has been “running and writing grants in the county for a long time,” said that there are several primary areas of focus of focus in the partnership including developing a larger workforce and improving the efficiency of systems in critical access hospitals.

“It’s all about the patients,” Traeder said. “That is what we really want to focus on.”

One aspect of the partnership is training military veterans to be able to transition from service directly into fields in health care. According to Traeder that transition has been hard in the past due to military training not carrying over and counting in the private sector.

“When they get stateside they can actually get a job immediately,” Traeder said. “We have a 20 percent unemployment rate among our veterans right now and one of the major problems is once they get home the nation doesn’t accept their training.”

Another aspect of the partnership is developing better communication and transportation protocols in critical access hospitals.

“One of the things we have identified is that we are using rotor transportation at a very high rate when ground transportation would be appropriate,” Traeder said. “Each time a rotary comes out to pick up a patient it is about $15,000 and sometimes as much as $30,000.”

In order to combat those costs the partnership is looking at improving ground transportation in critical access hospitals in order to have staff available to ride in an ambulance with a patient to give support to the patient that would otherwise require a helicopter for transportation.

Source: vp-mi.com

SLEMAN, suaramerdeka.com – Rumah Sakit Umum Daerah (RSUD) Sleman menargetkan realisasi kerjasama dengan Badan Penyelenggara Jaminan Sosial (BPJS) mulai tahun depan. Saat ini, pihak pengelola masih merintis sejumlah upaya untuk mencapai sasaran tersebut.

“Sesuai undang-undang, per 1 Januari 2014 seluruh penduduk harus tercover jaminan sosial. Kami kejar target itu karena 60 persen pasien merupakan peserta Askes dan jaminan kesehatan,” kata Direktur RSUD Sleman, Joko Hastaryo kepada wartawan, Rabu (1/5).

Mengacu UU no 42/2012, setidaknya ada tiga persyaratan yang harus dipenuhi rumah sakit sebelum menjalin kerjasama dengan BPJS. Salah satunya mengenai pemenuhan syarat kelas. Sampai awal tahun ini, RSUD Sleman baru memiliki 168 tempat tidur. Padahal, rumah sakit kelas B disyaratkan memiliki 200 unit tempat tidur.

“Tapi sekarang syarat itu sudah kami penuhi. Sejak awal Februari, fasilitas tempat tidur sudah ditambah jadi 214 unit,” ujarnya.

Namun demikian, masih ada kendala lain yakni menyangkut ketersediaan layanan spesialis penyakit jantung, dan ortopedi (bedah tulang). RSUD Sleman belum memiliki dua unit layanan tersebut. Selama ini, pasien ditangani dokter bagian lain atau dirujuk ke rumah sakit yang memiliki spesialisasi tersebut.

Mengatasi kendala ini, RSUD Sleman telah mengirimkan salah satu dokter umum untuk mengikuti pendidikan ortopedi. Namun penanganan khusus penyakit jantung masih dilakukan sebatas bekerjasama dengan RS Sarjito. Paling tidak satu minggu sekali, dokter spesialis jantung RS Sarjito berpraktik di RSUD Sleman.

Upaya lain terkait rencana kerjasama dengan BPJS adalah perbaruan akreditasi. Saat ini, baru 16 dari 23 layanan kesehatan di RSUD Sleman memiliki akreditasi. Beberapa unit layanan yang belum terakreditasi antara lain bedah tulang, jantung, patologi anatomi, dan sterilisasi sentral.

Tahun depan ditargetkan semua pelayanan mencapai angka kredit sesuai yang ditentukan. “Hal ini jadi salah satu fokus kami. Apalagi sistem penilaian akan berbeda, nantinya diawali implementasi standar dulu baru kemudian evaluasi dokumen,” terang Joko.

RSUD Sleman juga sedang menggenjot peningkatan layanan bagi masyarakat miskin. Pasalnya, syarat kerjasama dengan BPJS adalah rumah sakit harus menyediakan fasilitas layak untuk pasien tidak mampu. Salah satu upayanya adalah menambah fasilitas tempat tidur di ruang kelas III yang saat ini jumlahnya baru 55 persen.

Sumber: suaramerdeka.com

JAKARTA. Emiten properti PT Lippo Karawaci Tbk (LPKR) membukukan pertumbuhan pendapatan dan laba bersih yang cukup kinclong di kuartal I 2013. Salah satu penyumbang besarnya adalah bisnis rumah sakit, dengan pendapatan yang melejit 45% dari setahun lalu.

Pendapatan LPKR tumbuh 26%, dari Rp 1,17 triliun di triwulan I 2012, menjadi Rp 1,47 triliun. Lalu laba bersihnya juga meningkat 23% menjadi Rp 252 miliar, dari Rp 205 miliar setahun lalu.

Corporate Communications LPKR Danang Kemayan Jati mengatakan, kinerja ini didukung oleh pertumbuhan ekonomi Indonesia yang didorong oleh konsumsi dalam negeri. Dus, LPKR mencatat percepatan pertumbuhan pendapatan bisnis rumah sakit, penjualan perumahan, dan peningkatan produktivitas.

Menurutnya, semua divisi usaha LPKR memberikan hasil yang memuaskan di kuartal pertama ini. Bahkan, pendapatan divisi usaha rumah sakit melejit 45% menjadi Rp 584 miliar. Kenaikan tersebut sejalan dengan meningkatnya pendapatan rata-rata dari pasien rawat jalan dan rawat inap. Selain itu ada juga peningkatan kontribusi pendapatan dari rumah sakit-rumah sakit baru yang telah dibuka di Manado, Makassar, Bali, dan Palembang.

Sementara, pendapatan dari divisi usaha Residential & Urban Development naik 13% menjadi Rp 620 miliar,dari Rp 547 miliar setahun lalu.

Sedangkan pendapatan dari Townships meningkat 11% menjadi Rp 383 miliar. Demikian pula pendapatan dari Large Scale Integrated Developments yang naik 17% menjadi Rp 237 miliar, terutama dengan meningkatnya pengakuan pendapatan dari Kemang Village dan The St. Moritz.

Pendapatan dari divisi Commercial yang terdiri dari Retail Malls & Hotels, tumbuh 25% dibanding kuartal I tahun lalu menjadi Rp 143 miliar.

Terakhir, unit usaha Asset Management mencatat pertumbuhan 21% menjadi Rp 130 miliar. Ini karena peningkatan fee yang diperoleh sebagai bagian dari peningkatan dana kelolaan dua produk REIT yang disponsori LPKR.

Di luar itu, pendapatan recurring LPKR terus meningkat dan memberikan kontribusi 58% dari total pendapatan.

Presiden Direktur LPKR, Ketut Budi Wijaya mengatakan, kinerja keuangan dan operasional di kuartal pertama ini merefleksikan pembangunan yang berkelanjutan dari proyek-proyek di divisi usaha hospitals dan residensial. Siloam Hospitals saat ini mengoperasikan 12 rumah sakit dan 6 rumah sakit sedang dalam tahap konstruksi. “Kami berharap 4 sampai 5 rumah sakit baru akan dibuka tahun ini,”ujar Ketut Budi Wijaya.

Ketut menambahkan, bisnis Residential/Township LPKR juga makin mantap. “Seperti yang pernah saya sampaikan sebelumnya, aktivitas pembangunan mal-mal juga berjalan dengan baik, sejalan dengan usaha kami untuk mengembangkan sektor ritel moderen dan konsumen di seluruh pelosok tanah air,” tambahnya.

Sumber: http://investasi.kontan.co.id

Jakarta, PKMK. Developer real estate besar di Indonesia memiliki potensi berlomba masuk bisnis rumah sakit. Sebab, dari sisi potensi pasar ataupun tingkat pengembalian investasi, bisnis rumah sakit bisa lebih menguntungkan daripada bisnis real estate, ungkap Budi Santoso, pengamat properti (2/5/2013). Budi menjelaskan, orang sakit pasti tidak akan menunda berobat. Terlebih lagi kalangan menengah ke atas. Berbeda dengan masalah kesehatan, kalangan ini masih mungkin menunda pembelian apartemen, rumah, ataupun properti yang lain. “Kalau terletak di lokasi berkembang dan di daerah dengan pendapatan tinggi, bisnis rumah sakit bisa balik modal dalam lima sampai tujuh tahun,” kata penulis puluhan buku real estate tersebut. Bisnis real estate dan rumah sakit sama-sama berjangka panjang. Namun bisnis rumah sakit lebih bisa memberikan keuntungan jangka panjang. Bila kawasan real estate perumahan seluas 10 hektar dikembangkan intensif, maka bisa selesai dalam setahun. Namun satu kawasan rumah sakit bisadapat terus memberikan pendapatan dalam waktu 10 tahun ataupun lebih.

Dari segi manajemen real estate, rumah sakit lebih mengalirkan pendapatan. Sebab, pendapatan dari pasien bisa disebut murni masuk ke manajemen rumah sakit. Sementara, kawasan real estate dibebani oleh kewajiban mengembalikan sebagian keuntungan ke warga seperti dalam bentuk layanan kebersihan dan keamanan lingkungan. Hal yang dilakukan PT Lippo Karawaci bisa menjadi contoh menarik. Developer tersebut terus berekspansi membangun rumah sakit ke seluruh Indonesia. Di Balikpapan, Kalimantan, Lippo Karawaci telah membangun Rumah Sakit Siloam. “Padahal, Lippo Karawaci belum membangun kawasan real estate di Kalimantan. Beda dengan Agung Podomoro Land,” Budi menambahkan. Saat ini, Grup Ciputra juga tengah membangun rumah sakit. Ini disebabkan adanya potensi pasar yang menarik. Ada sebuah simbiosis antara kawasan real estate menengah ke atas dengan rumah sakit. “Warga terbantu dengan adanya rumah sakit dan rumah sakit bisnisnya berjalan,” ujar Budi.

TRIBUNNEWS.COM, JAKARTA – Mahkamah Agung (MA) mengapresiasi putusan Mahkamah Konstitusi (MK) yang menghapus peran peradilan dalam pembuatan akta kelahiran anak yang melampaui satu tahun.

Kepala Biro Hukum dan Humas MA, Ridwan Mansyur, mengatakan penyelenggaraan akta kelahiran atau status kependudukan memang tanggung jawab pemerintahan.

“Dengan tidak adanya kewajiban membuat ketetapan tentang akta kelahirannya maka otomatis akan memperpendek birokrasi dan memperpendek proses. Artinya masyarakat bisa lebih cepat dan mudah karena memang itu adalah tanggung jawab pemerintah untuk menyelenggarakan itu,” ujar Ridwan kepada wartawan di MA, Jakarta, Rabu (1/5/2013).

Atas putusan MK tersebut, lanjut Ridwan, dinas kependudukan dan catatan sipil harus kerja lebih ekstra dan lebih teliti. Untuk itu, Ridwan menyarankan ada kerja sama antara dinas tersebut dengan rumah sakit, klinik, atau bidan terkait pendataan anak yang baru lahir.

“Sehingga nanti ketika anak itu lahir jangan sampai mereka keluar dari rumah sakit belum ada status berupa akta. Artinya berikan kewenangan juga kepada rumah sakit atau klinik untuk menerbitkan kepengurusan akta kepada catatan sipil,” kata bekas Ketua Pengadilan Negeri Palembang itu.

Dikatakan Ridwan, jumlah anak yang belum memilikia akta kelahiran berkisar 30 ribu. Hal itu disebabkan bukan hanya karena orang tuanya tidak mampu dari segi biaya namun juga tidak memiliki akses.

“Oleh karena itu kenapa harus dijemput bola, yang artinya catatan sipil harus menjemput bola, jangan biarkan merek yang datang, bagaimana catatan sipil yang datang seperti halnya pengadilan negeri sidang keliling,” tukas alumnus Fakultas Hukum Universitas Sriwijaya, Palembang.

Sebelumnya, MK mengabulkan pengujian Pasal 32 ayat (2) UU Nomor 32 Tahun 2006 tentang Administrasi Kependudukan terkait proses pengurusan akta kelahiran yang melampaui satu tahun.

Sumber: http://www.tribunnews.com

SENTOLO – Pemkab Kulonprogo menargetkan Rumah Sakit Tipe D bisa beroperasi awal 2014. Pembangunan dilakukan menggunakan tanah kas desa di Desa Banguncipto, Sentolo.Bupati Kulonprogo Hasto Wardoyo mengatakan pembangunan RS Sentolo terus berjalan. Saat ini proses pembebasan lahan, sedangkan pembangunan fisik ditargetkan selesai Desember 2013.“Kemudian awal Januari 2014 mulai beroperasi meski belum sempurna,” kata Hasto, kemarin (29/4).Hasto menjelaskan, pembangunan tahap pertama menggunakan lahan 6.500 meter persegi. Pemkab juga berencana membangun Autis Center dengan lahan 6.000 meter persegi.“Nanti izin gubernur dengan kompensasi. Kami tidak menggunakan tanah warga karena tanah kas desa sudah mencukupi,” kata Hasto.RS tersebut mengantisipasi banyaknya pasien di RSUD Wates yang tidak dapat ditampung karena tempat tidur terbatas. Akan dilengkapi 100 tempat tidur dan diarahkan sebagai RS tanpa kelas.Hal ini untuk mengantisipasi pelaksanaan aturan Badan Penyelenggara Jaminan Sosial (BPJS). Sistemnya, setiap pasien yang dirawat mendapatkan layanan kelas I namun dengan biaya perawatan sama seperti harga kelas III.“Dengan aturan ini semua pasien diperlakukan sama oleh tenaga medis, tidak ada yang diprioritaskan,” kata Hasto.Bupati Hasto mengatakan RS tersebut akan dikembangkan menjadi pusat pengobatan kanker. Karena pelayanan kanker di DIJ tidak cukup memadahi, diharapkan mampu melayani pasien dari DIJ maupun Jateng.“Tenaga medis akan dioptimalkan dari RS dan puskesmas di Kulonprogo,” katanya.Kepala Badan Perencanaan Pembangunan daerah (Bappeda) Kulonprogo Agus Langgeng Basuki mengatakan, anggaran tahap pertama Rp 6 miliar dari APBD Kulonprogo. Sedangkan, anggaran yang dibutuhkan Rp 20 miliar dari APBD Provinsi.“Pembangunan secara bertahap. Kementerian Kesehatan juga akan memberi bantuan Rp 10 miliar dalam bentuk perawatan medis untuk mendukung beroperasinya RS tersebut,” kata Agus. (asa/iwa)

Sumber: http://www.radarjogja.co.id

Earlier today, the hospital announced it would bring in a strategy for dealing with violent patients after nurses threatened to strike following weeks of escalating emergency room violence.

The most recent attack was on Sunday when a man threw pieces of concrete at the waiting room, smashing four windows and terrifying staff and patients.

Monash Health media manager Suzana Talevski said the hospital would implement a protocol mid-year to deal with aggressive and violent patients and visitors, and immediately increase the number of security guards in the department.

ANF Victorian branch assistant secretary Paul Gilbert said it was a very positive response to nurses’ concerns.

“We will be recommending that at this stage they don’t exercise the powers to cease work under the Victorian workplace health and safety laws,” he said.

Dandenong nurses will meet tomorrow afternoon to discuss the new safety measures.

Source: heraldsun.com.au