Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

5
HOSPITAL FUNDING OF INDIGENT CARE IN SOUTH FLORIDA

Are the differences in local governmental funding mechanisms resulting in differences in other accountability measures, e.g., cost per day or staffing ratios?

To understand local public funding of care for the uninsured and its effect on hospitals, we analyzed the hospital financial data compiled and maintained by AHCA. Hospital management report these data according to detailed reporting instructions stipulated by the state (State of Florida, 1992). While hospitals report data according to their own fiscal years, we examine the data by calendar year. To smooth the effects of different reporting periods, we examine the trends in the financial information from 1998 through 2001.64

To facilitate the cross time comparisons, we made several adjustments to the data. First, we categorize the ownership of the hospital according to the ownership status in 2001. Two hospitals are affected by this decision Deering Hospital and Cleveland Clinic Hospital. Deering Hospital, previously a tax-paying hospital, was purchased by the Public Health Trust in 2000 and became tax supported. It is identified as tax supported across the four years. Cleveland Clinic Hospital was initially tax exempt but changed ownership status to tax paying. For this analysis, it is identified as tax paying across the four years.

Second, two “mergers” affecting four facilities occurred during this period of time. We have combined their information: Mount Sinai Medical Center includes the Miami Heart Institute, and Delray Medical Center includes Delray Medical Center - Fair Oaks Pavilion. These four facilities are identified as two throughout the analysis.


SOME BASIC DESCRIPTIVE MEASURES

Using these data, we calculated various metrics of productivity that could be used for accountability and reporting purposes. We calculated these measures at the hospital level and then aggregated by ownership type by

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64
The pre-1998 data are in a different computer format.

-59-

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