According to the Cabarrus Memorial Hospital Report (2008) and the concerns raised by George Batte (the board Chairman), the hospital is considering open heart surgery or coronary angioplasty because the lack of the service warrants the transfer of patients to other hospitals which greatly inconveniences the patients’ families. Other than the inconveniencing factor, the transfer of patients increases the risks of the condition worsening due to delayed treatment. Another factor calling for the consideration of the service is the fact that Dr.R.S. Christy desires to practice surgery at the hospital after finishing his fellowship in cardiovascular surgery but has pending offers from other hospitals which he might consider if CMH delays.
Essentially, both the hospital and the community fundamentally need the service because 80.1 percent of the patients suffering from cardiovascular conditions originate within the Cabarrus community. In addition, other populations from around the Cabarrus community visit the hospital with the same condition but have to be transferred to Duke University Medical Center edifying the urgent need to have the service. Another factor pressing the need for the service is the general growth of the population at risk of getting the condition. According to statistics, the population aged between 45 to 64 years likely to suffer from the condition is estimated to increase by 38.3 percent in the coming years. Additionally, the heart disease mortality rate within the state had increased considerably with most of the cases being reported within the Cabarrus County. Of all the sixteen open heart surgery programs located in the 11 counties, none of them was in the proposed service area of CMH. In fact, the closest one was 25 miles away in Charlotte. This phenomenon called for the urgent need to adopt the service at the hospital.
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For an individual to consider open heart surgery in a hospital, certain essential characteristics must be evident. The hospital must have an efficient service area that can adequately support patient volumes for the program. It must also have a Certificate of Need provided by the State’s Department of Health and Human Services. The hospital has to be accepted and recognized by other hospitals as an excellent facility. In addition, it has to be well equipped medically for the program with well qualified and competent staff. Finally, and perhaps the most important characteristic is the financial aspect. Patients will consider visiting hospitals that offer the cheapest rates for the procedure or program.
If the hospital has adequate reserves to underwrite most of the expenses such as medical equipment and renovations without borrowing money, then it is financially viable to offer the service. In considering the financial viability of a hospital in providing the service, certain predictive factors regarding costs and revenues have to be considered. First, if the costs of renovation and purchasing the required medical equipment can be met without going bankrupt, then it is viable to adopt the service. However, the revenues gained from offering the service should be able to offset the expenses within the second through to the third year. Put simply, the revenues earned annually should be more than the costs. For instance, with a rate of 80.1 percent of patients suffering from cardiovascular conditions in Cabarrus County coupled with the charge of 40, 957 dollars per procedure or case, the CMH is well viable to adopt the program or service.
Nevertheless, offering the service might give rise to certain unforeseen or unwarranted challenges. First, there is a risk of reduced revenues if the total rate of patients suffering from the condition reduces or if patients prefer a different hospital that perhaps offers cheaper rates. For instance, since the CMH is setting up the service for the first time, its charges might be higher than those of the Duke University Medical Center which has been offering the service for a long time. Another problem might be the opposition from surrounding hospitals after getting the CON mainly due to fear of competition. Finally, the lack of competent personnel such as a lead surgeon could be a challenge. For instance, CMH is looking to hire Dr. Christy as its lead surgeon after setting up the service. However, the doctor has other offers he has to consider within a short time frame which would be withdrawn if delayed. As such, if the doctor resolves to take up one of the offers then it would mean CMH will lack a surgeon for the service which might lead to increased mortality rate. The repercussions will also be felt financially if the patients choose to seek the services from other hospitals.
References
Case 19: The Case for Open Heart Surgery at Cabarrus Memorial Hospital. (2008). Web. Retrieved from: http://secure.expertsmind.com/attn_files/1918_Case-19_openheartsurgery.pdf
