This article was downloaded by: [University of Calgary] On: 29 March 2015, At: 15:52 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Hospital Topics Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vhos20
Operating Room: Open Heart Surgery — The Role of the Community Hospital Darrel Scott
a
a
Welborn Memorial Baptist Hospital , Evansville, Indiana, USA Published online: 13 Jul 2010.
To cite this article: Darrel Scott (1976) Operating Room: Open Heart Surgery — The Role of the Community Hospital, Hospital Topics, 54:1, 25-28, DOI: 10.1080/00185868.1976.9952372 To link to this article: http://dx.doi.org/10.1080/00185868.1976.9952372
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
0.R.
OPE1 HEfMT SURGfRlJ
The R o l e ot The
Downloaded by [University of Calgary] at 15:52 29 March 2015
Mr. Scott is an Assistant Director at Welborn Memorial Baptist Hospital, Evansville, Indiana. Prior to assuming his administrative post at Welbom, he was a Planning Associate for the Indiana Hospital Association consulting with member hospitals on health facilities and services. Mr. Scott received his MHA as an honor graduate of the Graduate Program in Health Administration, Indiana University School of Medicine, Indianapolis, Indiana, in 1971.
Community Hospital
By Darrel Scott
What role should a community hospital play in providing open heart surgery] This question has been frequently asked as hospitals across the county look to futureplanning in the establishment and development of new or dvferent services for their facilities. This question was asked by Welborn Memorial Baptist Hospital, Evansville, Ind., in 1973, evaluating this service for the first time. Thefact that another large community hospital also proposed providing this service at approximately the same time, made this service an intense health planning council issue.
he other hospital received approval and Welborn was denied approval by the Regional 314-BAgency. The State A Agency (DPA) upheld the decision. The hospital appealed the decision of the Agency through a hearing officer appointed by the governor and succeeded for the first time in the State of Indiana in having a decision of the State Agency overturned by a hearing officer. Welborn was then given the customary one year time limit to obligate capital funds for this project. The Regional B Agency then filed suit against the hospital, the state hearing officer, and its own State A Agency to whom it sends recommendations seeking to have the hearing officer’s decision reversed. This suit was regarded by many as an interesting case of a B Agency formally challenging the project review process of which it is a part. This law suit was also the first of its kind in the State of Indiana. Welborn was now faced with the possibility of having two facilities providing open heart surgery in a city of 150,000 and a medical referral area of 400,000. This caused Welborn and its medical staff a great deal of concern. The entire year for which approval was given was consumed in evaluation of the service.
T
JANUARY /F EBR UARY 1976
The final decision of the hospital and its medical staff was that the one year approval time limit was not sufficient for evaluation in light of the fact that another institution was providing the service on a low volume basis after receiving their approval to proceed. The Regional B Agency was so advised and informed that our evaluation was continuing and that the hospital would again come before them if we determined that another unit was necessary for this service area. First Survey on Subject
What did result from our one year study of the sevice was what is believed to be the first copyrighted national facility survey of open heart surgery in the country. The purpose of the survey was to determine what, in actual practice, is occurring across the country in the provision of this service. Over 99% of the hospitals that reported this service on their 1973 AHA annual report (latest available from AHA) were surveyed. Approximately 503 hospitals were surveyed and 222 (44%) responded. From the results of this survey, criteria can be determined and a resulting model drawn for community hospitals evaluating this service. 25
Downloaded by [University of Calgary] at 15:52 29 March 2015
1. History Of The Service Forty-five percent of the hospitals responding reported providing the service for more than ten years. Twenty-nine percent reported a program between five and ten years old and only twenty-five percent reported a service of newer than five years. Interestingly enough, twenty respondents reported that they are no longer doing open heart surgery. 2. Number of Cases Performed From Most Recent Year Nationally published criteria states from one - three cases a week are the minimum number of cases a week to maintain proficiency. The survey upheld this contention. Only twenty-six percent of those responding reported doing sixty cases a year or less. Fifty-one percent reported doing between sixty-one and two hundred fifty cases a year. Twenty-twopercent reported doing in excess of two hundred fifty cases a year. 3. Anticipated Number Of Cases For First Year Of Operation Responses to this question illustrated that surgeons have evidentally required a year to build a caseload. Fifty-two percent of the facilities repsonding reported doing twenty cases or less during their first year of operation. Thirty-six percent reported doing between twenty and eighty cases during their first year of operation. Only thirteen percent reported doing more than eighty cases during their first year of operation. 4. Population Base For Drawing Potentials For Open Heart Surgery The Survey indicates a minimum base of 250,ooO is required. Fifty-nine percent of the respondents reported a population base of 250,OOO - l,ooO,OoO.Twenty-three percent reported a population base of greater than one million. Only seventeen percent reported a population base of less than 250,ooO. This question did not, however, address itself to the number of open heart surgery services available in any one population base. 5. Number Of Surgeons On The Medical Staff Capable Of Operatlng As First Surgeon This question showed fairly even distribution from one -three surgeons. Twenty-two percent reported having one surgeon, twenty-seven percent reported having two, and, eighteen percent reported having three. Thirty-three percent of the respondents reported having four or more surgeons on their staff capable of operating as first surgeon. 6. Usual Number Of Surgeons Present During Each Procedure Results indicate two - three surgeons should be present during each procedure. Seventy-nine percent of those responding indicated two or three surgeons are present for each procedure. Sixteen percent reported four or five are present, only five percent reported one was present and no one reported more than five present. 7. Is The Surgical Staff Supported By A Physician House Staff For Post Operative Care? By more than a two to one majority this question was answered in the affirmative. Sixty-nine percent said “yes” and thirty-one percent said “no.” 8. The Number Of Pump Teams Utilized For Open Heart Surgery Procedures Sixty-six percent of those responding reported one team utilized for the surgery. Twenty-five percent reported two teams available. Ten percent reported three or more teams with no one showing more than five teams. 9. Are Pump Teams Maintained In-House Or Is The Service Contracted For With An Outside Agency? Eighty-five percent reported in-house teams; fifteen percent reported contract services. 10. The Number Of Personnel On Each Pump Team Fifty-six percent reported a two person team; seventeen percent reported three - four persons per team, while twenty percent reported a one person team. 11. Are Personnel On The Pump Team Utilized Exclusively For These Services - Or Do They Perform Other Duties? Sixty-one percent reported personnel are utilized for other
26
duties. Thirty-nine percent reported personnel are used exclusively for pump team services. 12. Are You Associated With A University Medical School? Sixty-one percent reported “yes” while thirty-nine percent reported “no.” 13. The Approximate Dollar Cost To The Patient (includes O.R. and usual surgery charges, any specific charge for the open heart surgery procedure pre- & post-operative hospitalization, recovery room)- (does not include surgeon’s fees or catheterization.) The approximate median for this question was at S5,ooO. Forty-nine percent reported charges of $5,ooOor less and fiftyone percent reported charges of greater than 5,OOO. The spread is fairly even showing a most typical bell curve:
so-
1,000
1,001 - 2,000 2,001 3,001
-
3,000
4,000
4,001 - 5,000 5,001- 6,000 6,001- 7,000 7,001 - 8,000 8,001 - 9,000 9,001 - 10,000 over 10,OOO
-
-
5% 6% 10% 10%
18% 17% 10%
wo 2%
6%
6%
From these results then, a model can be drawn to assist the community hospital in determining its role in open heart surgery.
Category
Criteria
Number of cases to expect in the first year of operation.
20 or less
Number of cases to expect after first year of operation.
1-5 cases per week
Population base needed for support Number of surgeons needed capable of operating as first surgeon
2
Number of surgeons needed for each procedure
2-3
Should the surgical team be supported by an in-house physician team for post operative care?
Yes
Number of pump teams required
1
Should the pump team be maintained in-house or contracted for with an outside agency?
Maintained in-house
Desirable number of persons needed for each pump team.
2 HOSPITAL TOPICS
OPEN HEART SURGERY SURVEY OF THE UNITED STATES Welborn Hemorial Baptist Hospital, InC. Evanaville. Indiana 47713 April, 1975
1.
The number of y e a r s the hospital has provided open heart surgery. 1 - 2 3 - 4 -
5
7
6
22 129
11 16%
18 9%
-
8
9
-
10
12
21
68
111
-
11
12
13
14 78
-
14
- 15
14
15
- 16
n
19
18
41
108
98
- 18
17
19
10 58
0
-
-
21
20
11 7%
41
40
25 1 Id
-
60
-
61
80
12
19
68
108
81
-
100
101
-
150
151
3n
21 118
zat
- 250
251
-
19
10
101
58
301
300
- 20
over 20
(totag -
5 38
191
13 78
The number o f open heart surgery cases from the last fiscal year or reporting period.
2.
-
350
over 350
21 128
9 58
(totall 188
The number o f open heart surgery cases performed during the first year of operation.
3.
o -
-
11
10
20
54
28
341
1 Ba
21
-
40
-
41
60
61
-
no
81
-
- 125
101
100
126
5
6 41
10 61
15 91
34 21%
-
150
151
38
- 200
201
2 18
1 lt
- 250
over 250
2
(total)
2 1t
18
159
The approximate population base f o r drawing patients for open heart murgery.
4.
under
L D O K_ _ loo_ - 25OK _ _ -
Downloaded by [University of Calgary] at 15:52 29 March 2015
-
-
250
19 15\
3 21
500K
500
31
-
750K
- In
750
18 141
251
1.0
-
1.5
1.sn
- 2.on
2.0
-
12
18
3
9
101
148
28
7t
2.51
2.5
-
over 3.OW
1 18
3M
world wide
5 41
(total)
7 6)
126
Copyright, Welborn Hemorlal Baptiat Ilospital, Inc. 1975
It is recognized that since the above is a model, reasonable variances of any one particular criteria may be expected depending on the facility providing the service. This survey also did not address specific quality of care criteria, such as mortality rates, etc., however, it is hoped that this survey and its resulting model can assist current programs in open heart surgery in evaluating its statistics against national performance criteria as well as assisting potentially new programs in evaluating their resource availability against current practice.
Can you expect to utilize pump team($ for other services? Should you be associated with a medical school? Anticipated charges for each procedure
Are the prsonnel on the -1
11.
- - l s c l u-Slve~ -~
uU112ed
exclusively for these services
11
121
19%
61%
or do they perform other dub=?
198
rrub/clrcul. research lati pllmnarylabcdth. lab N other
otller duues mlwie
-
(total)
- 4 X h e r duties-
-
total
12 17
9 21 3 59 121 (61%)
'Ihc nrntmr of h x p i t a l s dssocmted rnth a meal r h m r .
12
-AsY1ciated--
--mtAssoc1ataJ-79 39%
123
61% 11.
202
?he appro-te dollar a x t to the patient (mcludes opratmg ram ard usual surgery & a w e s , any specific charge for t h open heart sxyery procedure, pre h v t d p x a t i w tnspltallzatlon, renxeq nxm) kkes mlule surgEon's
-
fees or catheterizationl. O
0 - $1,000
9
5% Nn€:
1,001 - 2K 10 6%
2,001
-
3K
17
ioa
3,001
-
4K
18 10%
4,001
-
5K
5,001 - 6K
6,001 - 7K
31
30
18
18%
17%
10%
F i v e hurdred surveys =re wiled: tm hundred twenty-respnses were received. the neqatlve, SUCh as "m longer p r f o m g surgery - or - c m t ar)5wer."
7.001
16 98
8K
8,001 - 9K 4 28
10
10 6%
6%
Of that nurter rventy respnded in
Also see chart on next page
JANUARYIFEBRUARY 1976
W
9,001 - 10K
27
. .
Downloaded by [University of Calgary] at 15:52 29 March 2015
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45
56
22%
27t
36 1st
28
14t
16 8%
ia
5%
3
1%
4 2t
2
4
1%
2%
-a
-
204
6.
7.
I.
t h e s u r g i c a l r t a f f Pupportad by a p h y r i c i a n house r t a f f f o r p o s t - o p e r a t i v e care? (totall
--No--
--yes--
6Q
135 698
195
31%
8.
129 66t 9.
48 25%
11 6%
5
2%
Are p e r s o n n e l on the pump team(.)
2 1%
-a-
m a i n t a i n e d in-housa
o u t - r i d e agency? --In-House-158 85%
28
--Contract-27 15%
-a-
-a-
-0-
-a-
-0-
- o r - pump team rervices
195
c o n t r a c t e d for w i t h
(total) 185
HOSPITAL TOPICS
Hospital Topics Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vhos20
Operating Room: Open Heart Surgery — The Role of the Community Hospital Darrel Scott
a
a
Welborn Memorial Baptist Hospital , Evansville, Indiana, USA Published online: 13 Jul 2010.
To cite this article: Darrel Scott (1976) Operating Room: Open Heart Surgery — The Role of the Community Hospital, Hospital Topics, 54:1, 25-28, DOI: 10.1080/00185868.1976.9952372 To link to this article: http://dx.doi.org/10.1080/00185868.1976.9952372
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
0.R.
OPE1 HEfMT SURGfRlJ
The R o l e ot The
Downloaded by [University of Calgary] at 15:52 29 March 2015
Mr. Scott is an Assistant Director at Welborn Memorial Baptist Hospital, Evansville, Indiana. Prior to assuming his administrative post at Welbom, he was a Planning Associate for the Indiana Hospital Association consulting with member hospitals on health facilities and services. Mr. Scott received his MHA as an honor graduate of the Graduate Program in Health Administration, Indiana University School of Medicine, Indianapolis, Indiana, in 1971.
Community Hospital
By Darrel Scott
What role should a community hospital play in providing open heart surgery] This question has been frequently asked as hospitals across the county look to futureplanning in the establishment and development of new or dvferent services for their facilities. This question was asked by Welborn Memorial Baptist Hospital, Evansville, Ind., in 1973, evaluating this service for the first time. Thefact that another large community hospital also proposed providing this service at approximately the same time, made this service an intense health planning council issue.
he other hospital received approval and Welborn was denied approval by the Regional 314-BAgency. The State A Agency (DPA) upheld the decision. The hospital appealed the decision of the Agency through a hearing officer appointed by the governor and succeeded for the first time in the State of Indiana in having a decision of the State Agency overturned by a hearing officer. Welborn was then given the customary one year time limit to obligate capital funds for this project. The Regional B Agency then filed suit against the hospital, the state hearing officer, and its own State A Agency to whom it sends recommendations seeking to have the hearing officer’s decision reversed. This suit was regarded by many as an interesting case of a B Agency formally challenging the project review process of which it is a part. This law suit was also the first of its kind in the State of Indiana. Welborn was now faced with the possibility of having two facilities providing open heart surgery in a city of 150,000 and a medical referral area of 400,000. This caused Welborn and its medical staff a great deal of concern. The entire year for which approval was given was consumed in evaluation of the service.
T
JANUARY /F EBR UARY 1976
The final decision of the hospital and its medical staff was that the one year approval time limit was not sufficient for evaluation in light of the fact that another institution was providing the service on a low volume basis after receiving their approval to proceed. The Regional B Agency was so advised and informed that our evaluation was continuing and that the hospital would again come before them if we determined that another unit was necessary for this service area. First Survey on Subject
What did result from our one year study of the sevice was what is believed to be the first copyrighted national facility survey of open heart surgery in the country. The purpose of the survey was to determine what, in actual practice, is occurring across the country in the provision of this service. Over 99% of the hospitals that reported this service on their 1973 AHA annual report (latest available from AHA) were surveyed. Approximately 503 hospitals were surveyed and 222 (44%) responded. From the results of this survey, criteria can be determined and a resulting model drawn for community hospitals evaluating this service. 25
Downloaded by [University of Calgary] at 15:52 29 March 2015
1. History Of The Service Forty-five percent of the hospitals responding reported providing the service for more than ten years. Twenty-nine percent reported a program between five and ten years old and only twenty-five percent reported a service of newer than five years. Interestingly enough, twenty respondents reported that they are no longer doing open heart surgery. 2. Number of Cases Performed From Most Recent Year Nationally published criteria states from one - three cases a week are the minimum number of cases a week to maintain proficiency. The survey upheld this contention. Only twenty-six percent of those responding reported doing sixty cases a year or less. Fifty-one percent reported doing between sixty-one and two hundred fifty cases a year. Twenty-twopercent reported doing in excess of two hundred fifty cases a year. 3. Anticipated Number Of Cases For First Year Of Operation Responses to this question illustrated that surgeons have evidentally required a year to build a caseload. Fifty-two percent of the facilities repsonding reported doing twenty cases or less during their first year of operation. Thirty-six percent reported doing between twenty and eighty cases during their first year of operation. Only thirteen percent reported doing more than eighty cases during their first year of operation. 4. Population Base For Drawing Potentials For Open Heart Surgery The Survey indicates a minimum base of 250,ooO is required. Fifty-nine percent of the respondents reported a population base of 250,OOO - l,ooO,OoO.Twenty-three percent reported a population base of greater than one million. Only seventeen percent reported a population base of less than 250,ooO. This question did not, however, address itself to the number of open heart surgery services available in any one population base. 5. Number Of Surgeons On The Medical Staff Capable Of Operatlng As First Surgeon This question showed fairly even distribution from one -three surgeons. Twenty-two percent reported having one surgeon, twenty-seven percent reported having two, and, eighteen percent reported having three. Thirty-three percent of the respondents reported having four or more surgeons on their staff capable of operating as first surgeon. 6. Usual Number Of Surgeons Present During Each Procedure Results indicate two - three surgeons should be present during each procedure. Seventy-nine percent of those responding indicated two or three surgeons are present for each procedure. Sixteen percent reported four or five are present, only five percent reported one was present and no one reported more than five present. 7. Is The Surgical Staff Supported By A Physician House Staff For Post Operative Care? By more than a two to one majority this question was answered in the affirmative. Sixty-nine percent said “yes” and thirty-one percent said “no.” 8. The Number Of Pump Teams Utilized For Open Heart Surgery Procedures Sixty-six percent of those responding reported one team utilized for the surgery. Twenty-five percent reported two teams available. Ten percent reported three or more teams with no one showing more than five teams. 9. Are Pump Teams Maintained In-House Or Is The Service Contracted For With An Outside Agency? Eighty-five percent reported in-house teams; fifteen percent reported contract services. 10. The Number Of Personnel On Each Pump Team Fifty-six percent reported a two person team; seventeen percent reported three - four persons per team, while twenty percent reported a one person team. 11. Are Personnel On The Pump Team Utilized Exclusively For These Services - Or Do They Perform Other Duties? Sixty-one percent reported personnel are utilized for other
26
duties. Thirty-nine percent reported personnel are used exclusively for pump team services. 12. Are You Associated With A University Medical School? Sixty-one percent reported “yes” while thirty-nine percent reported “no.” 13. The Approximate Dollar Cost To The Patient (includes O.R. and usual surgery charges, any specific charge for the open heart surgery procedure pre- & post-operative hospitalization, recovery room)- (does not include surgeon’s fees or catheterization.) The approximate median for this question was at S5,ooO. Forty-nine percent reported charges of $5,ooOor less and fiftyone percent reported charges of greater than 5,OOO. The spread is fairly even showing a most typical bell curve:
so-
1,000
1,001 - 2,000 2,001 3,001
-
3,000
4,000
4,001 - 5,000 5,001- 6,000 6,001- 7,000 7,001 - 8,000 8,001 - 9,000 9,001 - 10,000 over 10,OOO
-
-
5% 6% 10% 10%
18% 17% 10%
wo 2%
6%
6%
From these results then, a model can be drawn to assist the community hospital in determining its role in open heart surgery.
Category
Criteria
Number of cases to expect in the first year of operation.
20 or less
Number of cases to expect after first year of operation.
1-5 cases per week
Population base needed for support Number of surgeons needed capable of operating as first surgeon
2
Number of surgeons needed for each procedure
2-3
Should the surgical team be supported by an in-house physician team for post operative care?
Yes
Number of pump teams required
1
Should the pump team be maintained in-house or contracted for with an outside agency?
Maintained in-house
Desirable number of persons needed for each pump team.
2 HOSPITAL TOPICS
OPEN HEART SURGERY SURVEY OF THE UNITED STATES Welborn Hemorial Baptist Hospital, InC. Evanaville. Indiana 47713 April, 1975
1.
The number of y e a r s the hospital has provided open heart surgery. 1 - 2 3 - 4 -
5
7
6
22 129
11 16%
18 9%
-
8
9
-
10
12
21
68
111
-
11
12
13
14 78
-
14
- 15
14
15
- 16
n
19
18
41
108
98
- 18
17
19
10 58
0
-
-
21
20
11 7%
41
40
25 1 Id
-
60
-
61
80
12
19
68
108
81
-
100
101
-
150
151
3n
21 118
zat
- 250
251
-
19
10
101
58
301
300
- 20
over 20
(totag -
5 38
191
13 78
The number o f open heart surgery cases from the last fiscal year or reporting period.
2.
-
350
over 350
21 128
9 58
(totall 188
The number o f open heart surgery cases performed during the first year of operation.
3.
o -
-
11
10
20
54
28
341
1 Ba
21
-
40
-
41
60
61
-
no
81
-
- 125
101
100
126
5
6 41
10 61
15 91
34 21%
-
150
151
38
- 200
201
2 18
1 lt
- 250
over 250
2
(total)
2 1t
18
159
The approximate population base f o r drawing patients for open heart murgery.
4.
under
L D O K_ _ loo_ - 25OK _ _ -
Downloaded by [University of Calgary] at 15:52 29 March 2015
-
-
250
19 15\
3 21
500K
500
31
-
750K
- In
750
18 141
251
1.0
-
1.5
1.sn
- 2.on
2.0
-
12
18
3
9
101
148
28
7t
2.51
2.5
-
over 3.OW
1 18
3M
world wide
5 41
(total)
7 6)
126
Copyright, Welborn Hemorlal Baptiat Ilospital, Inc. 1975
It is recognized that since the above is a model, reasonable variances of any one particular criteria may be expected depending on the facility providing the service. This survey also did not address specific quality of care criteria, such as mortality rates, etc., however, it is hoped that this survey and its resulting model can assist current programs in open heart surgery in evaluating its statistics against national performance criteria as well as assisting potentially new programs in evaluating their resource availability against current practice.
Can you expect to utilize pump team($ for other services? Should you be associated with a medical school? Anticipated charges for each procedure
Are the prsonnel on the -1
11.
- - l s c l u-Slve~ -~
uU112ed
exclusively for these services
11
121
19%
61%
or do they perform other dub=?
198
rrub/clrcul. research lati pllmnarylabcdth. lab N other
otller duues mlwie
-
(total)
- 4 X h e r duties-
-
total
12 17
9 21 3 59 121 (61%)
'Ihc nrntmr of h x p i t a l s dssocmted rnth a meal r h m r .
12
-AsY1ciated--
--mtAssoc1ataJ-79 39%
123
61% 11.
202
?he appro-te dollar a x t to the patient (mcludes opratmg ram ard usual surgery & a w e s , any specific charge for t h open heart sxyery procedure, pre h v t d p x a t i w tnspltallzatlon, renxeq nxm) kkes mlule surgEon's
-
fees or catheterizationl. O
0 - $1,000
9
5% Nn€:
1,001 - 2K 10 6%
2,001
-
3K
17
ioa
3,001
-
4K
18 10%
4,001
-
5K
5,001 - 6K
6,001 - 7K
31
30
18
18%
17%
10%
F i v e hurdred surveys =re wiled: tm hundred twenty-respnses were received. the neqatlve, SUCh as "m longer p r f o m g surgery - or - c m t ar)5wer."
7.001
16 98
8K
8,001 - 9K 4 28
10
10 6%
6%
Of that nurter rventy respnded in
Also see chart on next page
JANUARYIFEBRUARY 1976
W
9,001 - 10K
27
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45
56
22%
27t
36 1st
28
14t
16 8%
ia
5%
3
1%
4 2t
2
4
1%
2%
-a
-
204
6.
7.
I.
t h e s u r g i c a l r t a f f Pupportad by a p h y r i c i a n house r t a f f f o r p o s t - o p e r a t i v e care? (totall
--No--
--yes--
6Q
135 698
195
31%
8.
129 66t 9.
48 25%
11 6%
5
2%
Are p e r s o n n e l on the pump team(.)
2 1%
-a-
m a i n t a i n e d in-housa
o u t - r i d e agency? --In-House-158 85%
28
--Contract-27 15%
-a-
-a-
-0-
-a-
-0-
- o r - pump team rervices
195
c o n t r a c t e d for w i t h
(total) 185
HOSPITAL TOPICS
