McKinley Andrew
Issue Brief Health Policy Track Serv. 2004 Dec 31:1-12.
American health facilities are said to provide the best health care in the world. But hospitals are continually challenged by staff shortages, patient safety and medical errors, uninsured patients, and the growth of specialty hospitals. This issue brief provides an analysis of the issues that challenge hospitals' ability to provide quality care for patients. Moreover, the issue brief defines each issue, including staffing mandates, patient safety and medical errors, emergency hospitals, billing practices, and niche and specialty hospitals, outlines the arguments for and against each issue, and finally details and characterizes state legislative activity in regard to each issue. As of 2002, the most recent data available from the American Hospital Association (AHA), there were 5,794 registered hospitals in the United States. The AHA also states that there are 4,927 community hospitals, which includes non-governmental non-profit hospitals, investor-owned (for-profit) hospitals, and hospitals owned by state and local governments. The AHA defines community hospitals as all non-federal, short-term general, and other specialty hospitals. Specialty hospitals include obstetrics and gynecology, rehabilitation, orthopedic, and other individually described specialty services. Statistics provided by the AHA indicate that the number of rural and urban community hospitals is approximately equal--2,178 rural hospitals compared to 2,749 urban hospitals. However, this statistic alone does not address the quality of care in urban and rural settings. It does not address the total expenditures in rural and urban hospitals, nor does it address staffing levels.
据说美国的医疗设施提供着世界上最好的医疗保健服务。但医院持续面临着人员短缺、患者安全与医疗差错、未参保患者以及专科医院增长等挑战。本问题简报分析了那些对医院为患者提供优质护理能力构成挑战的问题。此外,该问题简报对每个问题进行了定义,包括人员配备要求、患者安全与医疗差错、急诊医院、计费做法以及小众和专科医院,概述了支持和反对每个问题的论点,最后详细介绍并描述了各州在每个问题上的立法活动。截至2002年,可从美国医院协会(AHA)获取的最新数据显示,美国有5794家注册医院。AHA还指出,有4927家社区医院,其中包括非政府非营利医院、投资者所有(营利性)医院以及州和地方政府所有的医院。AHA将社区医院定义为所有非联邦的短期综合医院和其他专科医院。专科医院包括妇产科、康复科、骨科以及其他单独描述的专科服务。AHA提供的统计数据表明,农村和城市社区医院的数量大致相等——农村医院有2178家,而城市医院有2749家。然而,仅这一统计数据并未涉及城乡医疗服务的质量。它没有涉及农村和城市医院的总支出,也没有涉及人员配备水平。