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THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN. Osaka March 1, 2014 Tokyo March 2, 2014 Lee Pickler, DBA. ACUTE CARE IN THE UNITED STATES ROLE OF LTAC’s. CURRENT HIGHLIGHTS OF HEALTHCARE TODAY

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the environment of acute care in the united states and a comparison with japan

THE ENVIRONMENT OF ACUTE CARE IN THE UNITED STATES AND A COMPARISON WITH JAPAN

Osaka March 1, 2014

Tokyo March 2, 2014

Lee Pickler, DBA

acute care in the united states role of ltac s
ACUTE CARE IN THE UNITED STATESROLE OF LTAC’s
  • CURRENT HIGHLIGHTS OF HEALTHCARE TODAY
    • UNTIL 2013 HEALTHCARE COSTS HAVE INCREASED EITHER ALARMINGLY OR AT LEAST SIGNIFICANTLY
    • FORTY-SEVEN MILLION AMERICANS EITHER UNDER-INSURED OR UNINSURED
    • THE DEMOGRAPHICS WILL NOT IMPROVE THE SITUATION—ONLY WORSEN IT
    • THE PRIVATE SECTOR HAS NOT BEEN ABLE TO ADDRESS THE PROBLEM
    • THE AFFORDABLE CARE ACT IS THE GOVERNMENT’S RESPONSE TO THE PROBLEM
the environment
THE ENVIRONMENT
  • DEMOGRAPHICS
  • MACRO ECONOMICS
  • HEALTHCARE RESOURCES
  • PUBLIC SECTOR
japan united states demographic comparisons
Japan United StatesDemographic Comparisons

2012 Population

Japan 127,515,000

U.S. 313,914,000

2013 Elderly (65+) %tage of Population

Japan 23.7%

U.S. 13.9%

notes on japan ltc
Notes on Japan -- LTC
  • Japan public spending on long-term care is projected to more than double from 1.4% in 2007, and could even reach 4.4% of GDP in 2050. Japan’s real public LTC spending is expected to grow at a faster rate between 2006 and 2025.
    • Highlights fromHelp Wanted? Providing and Paying for Long- Term Care, OECD Publishing, 2011.
japan united states macro economic comparisons
Japan United StatesMacro Economic Comparisons

2010 Health Expense Per Capita

Japan $3,958

U.S. $8,233

Health Cost %tage covered by the public (2011)

Japan 80.0%

U.S. 45.9%

http://www.oecd.org

japan united states macro economic comparisons1
Japan United StatesMacro Economic Comparisons
  • 2012 GDP Per Capita (in U.S. Dollars):
  • Japan US$46,720
  • U.S. US$49,965
resources
RESOURCES
  • Acute Care Beds Density per 1000 (2011)
  • Japan – 8 (Avg length of stay 17.9)
  • U.S. -- 2.6 (Ave length of stay 4.8)
  • Physician Density per 1000 (2010)
  • Japan – 2.23
  • U.S. -- 2.44
find a need and fix it
FIND A NEED AND FIX IT
  • GOVERNMENT POSITION—REGULATE AND PRICE FIX. RESULT WILL BE ADJUSTMENTS MADE BY THE PRIVATE SECTOR TO ADDRESS THE PROBLEM.
  • PRIVATE SECTOR CHANGED ACORDING TO WHO HAD THE POWER.
  • PHYSICIAN POWER, INSUROR POWER
the result
THE RESULT
  • NO INCREASE IN PATIENT ACCESS
  • INCREASED COST OF CARE
    • DUE TO THIRD PARTY PAYORS
    • TECHNOLOGY
    • SERVING THE UNDER-SERVED
  • NOTHING FIXED SO THEREFORE:
  • OBAMA CARE (THE AFFORDABLE CARE ACT)
two challenges
TWO CHALLENGES
  • ACCESS TO CARE FOR EVERYONE
    • IMPROVE COVERAGE
  • DRIVE COST OUT
    • SOME METHODS:
      • REGULATE INSURORS
      • CONTROL/DECREASE REIMBURSEMENT
      • BEGIN TO BUNDLE PRICING
      • DON’T PAY FOR MISTAKES
delivering care in this environment
DELIVERING CARE IN THIS ENVIRONMENT
  • SHORT TERM ACUTE CARE
  • LONG TERM ACUTE CARE
  • INPATIENT REHABILITATION
  • SKILLED NURSING FACILITY
  • HOME CARE
ltach definition
LTACH DEFINITION
  • LONG TERM ACUTE CARE HOSPITALS PROVIDE SPECIALIZED ACUTE CARE FOR MEDICALLY COMPLEX PATIENTS WHO ARE CRITICALLY ILL WITH MULTI-SYSTEM COMPLICATIONS AND REQUIRE LONG HOSPITALIZATIONS.