Department of Health Systems Administration, Georgetown University, Washington, DC, USA.
Health Care Manage Rev. 2013 Jul-Sep;38(3):201-10. doi: 10.1097/HMR.0b013e31825f3e16.
For many years, hospitals have relied on nonpatient care activities to complement patient care revenues and strengthen financial performance. For hospitals that lose money on patient care, nonpatient care revenues may mean the difference between net income and loss. Little is known currently, however, about whether nonpatient care revenues allow hospitals with negative patient care margins to offset their losses.
The aims of this study are (a) to examine whether hospitals rely on income from nonpatient care activities to offset losses on patient care and (b) to identify characteristics of hospitals that are able to offset such losses.
Data for this study came from the state of California. The sample consisted of not-for-profit and investor-owned short-term general acute care hospitals for the years 2003-2007. Descriptive statistics were used to compare hospitals with negative patient care margins that were able to offset patient care losses to hospitals that were unable to do so.
Between 2003 and 2007, approximately 40% of study hospitals lost money on patient care. Of these, only 25% relied on nonpatient care income to offset losses. Hospitals that were able to offset patient care losses tended to be larger, not-for-profit organizations that were able to generate substantial shares of their total revenues from nonpatient care activities, in particular, charitable donations and financial investments.
Despite claims that income from nonpatient care activities frequently allows hospitals to offset patient care losses, this study showed that only a small proportion of hospitals were able to do so. The financial viability of hospitals with negative patient care margins will thus depend on their ability to (a) deliver high-quality care profitably, (b) derive income from other operating activities, and (c) generate income from financial investments and engage in active development efforts to increase donations and gifts.
多年来，医院一直依赖非医疗护理活动来补充医疗护理收入并增强财务业绩。对于那些在医疗护理上亏损的医院来说，非医疗护理收入可能意味着收支平衡与亏损之间的区别。然而，目前对于非医疗护理收入是否能够让那些医疗护理利润率为负的医院抵消亏损，人们知之甚少。
本研究的目的是：（a）检验医院是否依赖非医疗护理活动的收入来抵消医疗护理的亏损；（b）确定能够抵消此类亏损的医院的特征。
本研究的数据来自加利福尼亚州。样本包括非营利性和营利性的短期普通急性护理医院，时间跨度为 2003-2007 年。描述性统计用于比较那些能够抵消医疗护理亏损的、利润率为负的医院和那些无法抵消亏损的医院。
在 2003 年至 2007 年间，约有 40%的研究医院在医疗护理上亏损。其中，只有 25%的医院依赖非医疗护理收入来抵消亏损。能够抵消医疗护理亏损的医院往往规模更大，是非营利性组织，能够从非医疗护理活动中获得大量收入，特别是慈善捐款和金融投资。
尽管有人声称非医疗护理活动的收入经常可以帮助医院抵消医疗护理的亏损，但本研究表明，只有一小部分医院能够做到这一点。因此，利润率为负的医院的财务生存能力将取决于它们能否：（a）以盈利的方式提供高质量的护理；（b）从其他运营活动中获得收入；（c）从金融投资中获得收入，并积极开展发展工作，以增加捐款和礼物。
