Eduardo Petazze’s Post

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Organization by profit center, when hospitals compete on price or are for profit. The idea is that each service is a profit center, even if they are support services (they do not bill the patient directly but inter-bille to the main service). Service managers are incentivized to become cost leaders (through bonuses associated with their profit), which guarantees the competitiveness of hospital rates. The following is a list of the largest for-profit hospitals in the United States, ordered by number (400 or more) of beds. It is about approximating the quality of medical care and innovation through applied research, when hospitals compete to maximize their financial results. 1. Methodist Hospital (San Antonio) — 1,536 2. Edinburg (Texas) Regional Medical Center — 816 3. Henrico Medical Hospital (Richmond, Virginia) — 812 4. North Shore Medical Center (Miami) — 775 5. CJW Medical Center – Chippenham Campus (Richmond, Virginia) — 762 6. Medical City Hospital (Dallas) — 668 7. University of Oklahoma Medical Center (Oklahoma City)—668 8. Plantation General Hospital (Fla.) — 655 9. Sunrise Hospital and Medical Center (Las Vegas) – 642 10. Brookwood Medical Center (Birmingham, Alabama) - 631 11. Clear Lake Regional Medical Center (Webster, Texas) - 627 12. Las Palmas Medical Center (El Paso, Texas) - 599 13. TriStar Centennial (Nashville, Tenn.)—595 14. McAllen Medical Center (Texas)—542 15. Doctors Hospital at Renaissance (Edinburgh, Texas): 530 16. Hillcrest Medical Center (Tulsa, Oklahoma) - 529 17. West Florida Hospital (Pensacola) — 515 18. Providence Memorial Hospital (El Paso, Texas) - 508 19. Wesley Medical Center (Wichita, Kansas) - 507 20. St. Francis Hospital (Memphis) — 499 21. Hahnemann University Hospital (Philadelphia)—496 22. Saint Mary's Medical Center (West Palm Beach, Florida) - 464 23. Summerlin Hospital Medical Center (Las Vegas) - 454 24. Saint David Medical Center (Austin, Texas): 451 25. JFK Medical Center (Atlantis, Florida) — 448 26. Park Plaza Hospital (Houston) — 444 27. Parkridge Medical Center (Chattanooga) - 435 28. North Shore Medical Center – FMC Campus (Fort Lauderdale, Florida) – 434 29. Northwest Houston Medical Center (Houston) - 430 30. Poplar Bluff (Mo.) Regional Medical Center - North Campus - 423 31. Corpus Christi Medical Center (Texas) - Regional Physicians - 421 32. Hospital System of the Carolinas (Florence, S.C.) — 419 33. Kendall Regional Medical Center (Miami) — 412 34. Wilkes-Barre General Hospital (Pa.) — 412 35. Bayshore Medical Center (Pasadena, Texas) — 406 36. Fountain Valley Regional Hospital and Medical Center (California) — 400

My comment: Successful organizations are either quality leaders (with acceptable costs) or cost leaders (with products or services of acceptable quality). On many occasions the consumer prefers quality and in others a more convenient price. Argentina, under a likely new government, is preparing to redefine the way publicly run state and national hospitals collect their revenue. The proposed new scheme (payment for medical services by patients or their health insurers and, at best, state reimbursement to poor patients), definitely embraces the price competition scheme (i.e. hospitals will try to be cost leaders). That is, patients become rational consumers who, faced with their pathology, face their preference for price or quality. The concept of patient as consumer was applied during the tenure of Margaret Thatcher in the 1980s, who abolished universal rights to well-being to emphasize individualistic rights and choice of services. The system failed. We will soon see how Argentines fare, in terms of health, education and other services provided by the State, once the changes projected by a probable new right-wing government are implemented.

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Note 2 - Benefits and implications of competing on process excellence We use actual improvements in * cost per discharge (CPD), * average length of stay (ALOS), and * conformance quality (ConfQual) https://www.sciencedirect.com/science/article/abs/pii/S092552731830207X

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Note - America's Best Hospitals, listed in alphabetical order. The 22 Best Hospitals excel across most or all types of care evaluated. Hospitals received points if they were nationally ranked in the 15 specialties – the more specialties and the higher their rank, the more points they got – and if they were rated high performing in any of the 21 procedures and conditions. https://health.usnews.com/health-care/best-hospitals/articles/best-hospitals-honor-roll-and-overview

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