Thread: Cutting hospital costs to help healthcare

This is just one example and it is currently a dilemna affecting almost every hospital in the country. There is a difference in opinion between the C-level and purchasing and the medical practicioners on what to do about this situation. One is focused on cutting costs, maximizing profits while the other is focused on preventing and curing people from disease. The catch is, to effectively cut costs, in this situation, you are placing 2 million people in danger of losing their life.

More people die every year from hospital infections (90,000) than from all accidental deaths (70,000), including motor vehicle crashes, fires, burns, falls, drownings, and poisonings. Each year, 2 million are affected. Nosocomial urinary tract infections (NUTI), which occur while a catheter is in place, is one of the leading infections that kill.

Currently on the market, there are two major Foley catheters. One is your basic IC Catheter. This runs the hospital $2.95. The other is a silver coated anti-bac catheter that runs the hospital $101.95. The latter in studies has been shown to reduce NUTI by over 70%. Yet only 1400 hospitals are using it. Why? Because of cost. Because of cost, they are knowingly allowing patients to be given a catheter that could potentially cause them to develop a NUTI and possibly die when they are aware that a better alternative is out there. And the patient has no say in this decision. Most Dr's don't even have a say. CNN, Newsweek, and other major MSM have written articles about the advancements available, yet purchasing is still roadblocking many institutions from allowing their practicioners to use this item because of cost.

With the current need, or obsession, to cut costs, is cutting costs in this instance going to help our overall healthcare? Is sometimes the saying, 'you get what you pay for' really true? The irony of the situation is, when someone does develop a NUTI, it generally will cost the hospital 20-40K to treat the problem that could have likely been avoided if the decision makers had chosen to spend an extra $98 up front. Currently, purchasing is willing to take that chance to save money on the item.

This is only one instance where they accept the cheapest yet most inferior product to give their patients to lower their overall costs. I see this type of thing almost daily in the VA hospitals I visit.

Is this the way to go?

Originally Posted by freckles

This is just one example and it is currently a dilemna affecting almost every hospital in the country. There is a difference in opinion between the C-level and purchasing and the medical practicioners on what to do about this situation. One is focused on cutting costs, maximizing profits while the other is focused on preventing and curing people from disease. The catch is, to effectively cut costs, in this situation, you are placing 2 million people in danger of losing their life.

More people die every year from hospital infections (90,000) than from all accidental deaths (70,000), including motor vehicle crashes, fires, burns, falls, drownings, and poisonings. Each year, 2 million are affected. Nosocomial urinary tract infections (NUTI), which occur while a catheter is in place, is one of the leading infections that kill.

Currently on the market, there are two major Foley catheters. One is your basic IC Catheter. This runs the hospital $2.95. The other is a silver coated anti-bac catheter that runs the hospital $101.95. The latter in studies has been shown to reduce NUTI by over 70%. Yet only 1400 hospitals are using it. Why? Because of cost. Because of cost, they are knowingly allowing patients to be given a catheter that could potentially cause them to develop a NUTI and possibly die when they are aware that a better alternative is out there. And the patient has no say in this decision. Most Dr's don't even have a say. CNN, Newsweek, and other major MSM have written articles about the advancements available, yet purchasing is still roadblocking many institutions from allowing their practicioners to use this item because of cost.

With the current need, or obsession, to cut costs, is cutting costs in this instance going to help our overall healthcare? Is sometimes the saying, 'you get what you pay for' really true? The irony of the situation is, when someone does develop a NUTI, it generally will cost the hospital 20-40K to treat the problem that could have likely been avoided if the decision makers had chosen to spend an extra $98 up front. Currently, purchasing is willing to take that chance to save money on the item.

This is only one instance where they accept the cheapest yet most inferior product to give their patients to lower their overall costs. I see this type of thing almost daily in the VA hospitals I visit.

Is this the way to go?

Great post as I sit in the clean room at my work at a implantable medical device company. Here is my impression of why that catheter cost that much and why it's not used more frequently. It should be noted that this is my opinion only.

A company spends hundreds of millions of dollars in R&D work to bring a single product to market. Additionally, the US, EU and Japan all have different approval bodies that must be satisfied. This drives up the R&D costs exponentially, as they all have different standards. Then when all is said and done, you have 7 years before that product's patent expires and generic versions can be produced. Seven years to not only create a profit but also to recoup half a billion dollars worth of financial outlay.

Drive the approval costs down by having one sanctioning body, and drive down product cost, making it more financially feasible to give patients the care that they deserve.

Originally Posted by Think for myself

Great post as I sit in the clean room at my work at a implantable medical device company. Here is my impression of why that catheter cost that much and why it's not used more frequently. It should be noted that this is my opinion only.

A company spends hundreds of millions of dollars in R&D work to bring a single product to market. Additionally, the US, EU and Japan all have different approval bodies that must be satisfied. This drives up the R&D costs exponentially, as they all have different standards. Then when all is said and done, you have 7 years before that product's patent expires and generic versions can be produced. Seven years to not only create a profit but also to recoup half a billion dollars worth of financial outlay.

Drive the approval costs down by having one sanctioning body, and drive down product cost, making it more financially feasible to give patients the care that they deserve.

It's a good opinion. Basically, because of the intervention of multiple governing bodies, costs are being driven up. It's unrealistic to force the manufacturer to reduce their overall profit margin. It's also unfair, but if they can reduce the overall cost of production however they can do so, they can lower the cost to the consumer without decreasing margin, which is something most will do if they hope to survive.

How about a system that would make it more lucrative to have a patient heal quickly and get a new one in? Like the patient having to pay a lot less if he/she gets an infection while in hospital?

Seems like that if you want healt care to be run as a normal business, you need additional controlling mechanisms. It is naive to think that free market mechanisms alone will ensure that the ones providing the best care will win in the long run, as there are no way I could know about that catheter stuff as a normal patient.

As for cutting other costs, find a way to reduce paperwork, and you will win the nobel prize in medicine.

I have no knowledge of these things, but is there any way to assess a patients risk of developing infection and if it's high give them the more expensive catheter, while giving low risk patients the cheaper one?

Originally Posted by Blueneck

I have no knowledge of these things, but is there any way to assess a patients risk of developing infection and if it's high give them the more expensive catheter, while giving low risk patients the cheaper one?

No more than being able to predict if you will get a cold this winter.

Originally Posted by Blueneck

I have no knowledge of these things, but is there any way to assess a patients risk of developing infection and if it's high give them the more expensive catheter, while giving low risk patients the cheaper one?

Yes. The longer you have to be catheterized, and the lower the urinary output, the higher the risk for infections + add neurologic reasons for micturition problems or prostate hyperplasia, etc.

The impact of an infection from a catheter is dependent on your overall condition, typically patients getting severe complications have suffered from a severly debilitating disease in the first place.

Originally Posted by chu chu rocket

Yes. The longer you have to be catheterized, and the lower the urinary output, the higher the risk for infections + add neurologic reasons for micturition problems or prostate hyperplasia, etc.

The impact of an infection from a catheter is dependent on your overall condition, typically patients getting severe complications have suffered from a severly debilitating disease in the first place.

That was what I meant. Thank you.

When my father was dying of throat cancer he stroked out towards the end and home health catheterized him. It got plugged up somehow and his potassium level went up to what the doctor said later was "beyond a point that was consistent with life", although it didn't kill him.

Sometimes I think procedures like catheterization are really more for the convenience of the caretakers than what's good for the patient.

I work at a hospital that back at the beginnning of November had to close down the entire ICU part of the hospital because of a drug resistant bacteria infection called acinetobacter. The news about it hit the media like wildfire. Everyone, including, pts and employees were scared because it seemed not many people knew too much about it. We were told that it came from Iraq. Apparently maybe a soldier had brought it back and the germs from it spread. You could get it from the bedrails, on clothes, etc. Very contaigous. You can read more about it here Hospital restricts ICU after outbreak

Originally Posted by chu chu rocket

As for cutting other costs, find a way to reduce paperwork, and you will win the nobel prize in medicine.

That's simple: reduce government oversight of medicine.