Cheney (2016) states that the difference is based on the cultural approach to managing the economics of healthcare. In the case of hospitals, they all serve patients and employ providers and nurses as primary personnel and they operate in the same regulatory framework for the delivery of health-related services. The for-profit hospitals have an additional element: their need to generate a return for their investors. Thus, the culture in the for-profit organization is business-driven while the culture at non for-profit is service-driven. Both types of organizations focus on delivering the highest-possible quality of care, they are both accountable for the services they deliver, their ability to be good stewards of the operations and to make the organizations great places to work for their employees. Neither type can afford to ignore sustainability or patient-care excellence. Rubin (2015), states reviews from the United States Renal Data System in 2014 showed that when data are adjusted by the pre-dialysis nephrology care, there is no difference in either hospitalization or mortality for patients with end stage renal disease (ESRD).
Cheney, C. (2016). Differences between NPFS and for-profits are marginal. HealthLeaders. Retrieved from https://www.healthleadersmedia.com/finance/differences-between-nfps-and-profits-are-marginal
Rubin, R. (2015). For-profit/not-for-profit healthcare: What’s the difference? Challenging assumptions based on hospitals’ business models. MedPageToday, retrieved from https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/51317
DNP-835 Week 3 DQ 2 Respond to Gary
Ethics will always be a matter of opinion. When examining if a not for profit or a for profit hospital provides more ethical care this authors opinion on it depends highly on the organization and the organizational culture. Both models need to make more money than they spend in order to pay bills and keep the doors open to care for patients. Cheny (2017) describes five major differences in the two models; Tax status, operational discipline, financial pressure, scale, and competitive edge. I disagree with almost all the authors points saying for profit organizations exceed in all of the above minus taxes. Both models must operate with a positive margin to invest, repair, and upgrade. While for profits must make dividends for investors, not for profits must keep high ratings in order to issue and repay bonds. Everyone is under tremendous pressure. Scale is not exclusive to for profit systems. Large for-profit systems are currently operating at losses. Whole large not for profit systems do well. So, competitive edge? It depends on the system. No, on model does not provide more ethical care.
The best example I can give is a conversation I had with my peer at a competing for profit center in my city. We were at a friend’s party and complaining about work. I was complaining that we couldn’t keep our OR volumes and he said he wishes that was his case. He stated that his members pay a monthly fee for their care whether its used or not. If they need expensive care like admission, CTs, or OR it’s a negative. However, because of this that organization spends tremendous time, effort, and money on primary care and preventive services. They really lead the way in keeping people out of the hospitals and it seems we do ok at the preventative and really good at acute care. They are different philosophies for sure. It would be ideal to do both.
Cheney, C. (2017). Top 5 differences between NFPS and for-profit hospitals. Retrieved from https://www.healthleadersmedia.com/
finance/top-5-differences-between-nfps-and-profit-hospitals