Evening star., 1948-10-06

those unable to pay large bills,
leaders are banking their hopes on
a growing number of patients being
able to pay their own way.
Until that time comes, authorities
sagree hospitals should tighten their
administrative efficiency and put
hospital rates and charges on more
realistic business basis. In most
hospitals the actual cost of giving
specific services bear little direct
relationship to the charges made for
them.
Ward Rates Below Cost.
Rates for beds in wards almost
Invariably are below cost and many
patients in private roms pay con-
Siderably more than cost.
But, actually, leaders say, it costs
as much to care for a patient in a
ward as in a private room.
Most hospital bills are based on
two sets of charges. One is a speci-
fed rate for use of the hospital
room, food, nursing and few other
services. The other is for the So
called extra services which vary
according to treatment. 1t includes
drugs, X-rays, anesthesia, blood
transfuSions, special laboratory work
and other expenses.
At the recent sessions of the
American Hospital Association Con-
ventlon. DR.. A. c. Bachmeyer, di-
rector of the University of Chicago
Clinics, said that while a hospitals
special services represent only 30
per cent of its expenses, they pro-
duce so per cent Of its income.
At the meeting nearly every one
agreed in a discussion that ward
rates should be near cost. But
every one also agreed that they
aren't.
There are also broad differences
in steps to adjust rates to meet
increased costs.
One hospital administrator told
a reporter he would like to raise
room rates, but that he had added
raises to extra service" charges
instead The reason is that higher
room rates would have put us too
much above rates in other hospitals
in our community" he added The
public wouldn't have understood it"
Must Act Together.
From this, it would seem that
if increased costs honestly are to
be passed on to the public, hospitals
must act together in determining
such moves.
Basing rates on. costs is not solely
a matter of fairness to patients.
The practice also would give hos
pitals a sounder basis on which to
negotiate contracts with Govern
ment and other agencies for re-
endorsement of the costs for treat
ing low-income patients.
A recent editorial in the Medical
Annals of the District Medical So
ciety pointed out that before hos
pitfalls can justify costs to such
agencies, they must have uniform
system of accounting.
What this means simply is that
hospitals here all should group the
same expenses in the same cate
gories when computing costs. Then
different hospitals can be compared
fairly.
Different costs are justifiable be-
cause expenses vary greatly in diff
ferent hospitals. The type Of treat
ment given is one of many factors.
Another is that in Catholic hospitals
costs may be less because sisters
carry out many administrative
functions done by paid employees
in other institutions.
Lack of Unified Accounting.
But both Congress and the Com
munity Chest Federation recently
called attention to the lack of uni
fled accounting in drawing contracts
with the hospitals. The Metro
politan Health Survey two years ago
said that Washington hospitals were
in "the Dark Ages" about account
ing and statistics. Hospital officials
agreed to the need for unified
accounting plan then. the survey
reported. But nothing has been
done about it yet.
The closest approach is the cost
system worked out by auditors for
Group disqualification, Inc. which
determines how much the group
pays different hospitals.
Unified cost accounting has been
carried out effectively by hospital
councils in other communities.