Academic journal article Health Care Financing Review

Recent Health Care Developments

Academic journal article Health Care Financing Review

Recent Health Care Developments

Article excerpt

New Tobacco Industry Documents Website Unveiled

Health and Human Services (HHS) Secretary Donna E. Shalala recently announced a single Federal source for Internet access to more than 27 million pages of tobacco industry documents that illustrate the health dangers of tobacco. The newly unveiled website was created in response to an Executive Memorandum issued by President Clinton.

"This project lifts the tobacco industry's veil of secrecy so that everyone can know the origins of today's epidemic of teenage smoking and the history of our national addiction to tobacco," President Clinton said. "These important documents tell in the industry's own words the extent to which vital public health information has been systematically concealed from the public."

This new website will allow users, for the first time, to conduct full-text searches of key documents made public by State lawsuits, congressional subpoenas, and the November 1998 master settlement agreement between the States and tobacco companies. This website was developed, coordinated, and housed by HHS's Centers for Disease Control and Prevention (CDC), and is the CDC's largest fully searchable database of electronic documents ever and the only place where the entire index of documents housed at the Minnesota Tobacco Document Depository is merged and available online in a searchable format.

Secretary Shalala also announced the results of a new CDC study showing that the prevalence of cigarette smoking among adults in all 50 States and the District of Columbia in 1998 remained virtually unchanged from 1996. The study underscores the addictiveness of tobacco use but also highlights gains that are possible at the State level. The study reported that State-specific smoking rates ranged from a high of 31 percent in Kentucky to a low of 14 percent in Utah. This website can be found at www.cdc.gov/tobacco.

Large Decline Reported in New York City Hospital Inpatient Census

The average daily census at New York City hospitals fell by 26.9 percent between 1990 and 1998, according to Hospital Watch, a quarterly report on hospital utilization and financial performance issued by the United Hospital Fund. The rate of decline in the city surpassed that of the Nation (20.6 percent), with most of the city's decline occurring in the latter half of the period (1994-1998).

The census decline was driven by reductions in average length of stay. Average length of stay fell from 10.1 days in 1990 to 7.2 days in 1998, a 29-percent decline. The number of discharges rose by 3.4 percent during the period.

The report sheds new light on predictions that the growth of managed care would lead to large declines in the inpatient census at New York City hospitals. According to Hospital Watch, other factors played a more important role in the declines seen to date. These include the movement of care to outpatient settings, declines in several epidemics such as acquired immunodeficiency syndrome, tuberculosis, substance abuse, and crime-related trauma that had led to overcrowding in the city's hospitals through the early 1990s, and the introduction of new technologies that have reduced hospital stays.

The September 1999 issue of Hospital Watch reports on trends in utilization, operations, and financial performance of New York City hospitals through December 1998. It is based on analysis of Institutional Cost Reports filed by each New York City hospital, analysis of responses to a survey conducted by the United Hospital Fund, and the hospitals' audited financial statements.

The United Hospital Fund is a philanthropic and health services research organization addressing critical issues affecting hospitals and health care in New York City.

California Expansion of Children's Health Insurance Program Approved

California officials expect that the recently approved expansion of the Healthy Families Program, the State's separate Children's Health Insurance Program (CHIP), will enroll an estimated 132,000 additional children by September 2001. …

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