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January 15, 2006
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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

January-February Health Affairs Surveys Challenges Facing Hospitals

How can hospitals adapt to today's competitive marketplace while continuing to provide comprehensive health care to all? That's one of the primary questions raised in "U.S. Hospitals: Mission vs. Market," the January-February issue of Health Affairs.

Will hospitals go the way of airlines? Stuart Altman, David Shactman, and Efrat Eilat, detail how similar challenges did in America's traditionally dominant airlines, and they warn: "U.S. hospitals could begin to resemble U.S. airlines: severely cutting costs, eliminating, services, and suffering financial instability."

Hospital pricing: Christopher Tompkins, Altman, and Eilat discuss the evolution of hospital "chargemasters," which vary in unpredictable ways from hospital to hospital and which increasingly apply only to the uninsured."

Specialty hospitals: In an article on specialty hospitals, Stuart Guterman goes beyond the allow-them-or-not debate to explain the systemic problems revealed by the proliferation of these institutions."

Print editions of the January/February issue, "U.S. Hospitals: Mission Vs. Market," may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

National Health Spending in 2004: Recent Slowdown Led By Prescription Drug Spending

A significant decline in prescription drug spending growth helped slow the pace of U.S. health spending to its lowest level in four years, according to a report by actuaries at the Centers for Medicare and Medicaid Services published in the January-February issue of Health Affairs. National health care spending grew 7.9 percent in 2004, down from 8.2 percent in 2003 and drug spending slowed to single digits or the first time in a decade, rising 8.2 percent.

Nurse Staffing in Hospitals: Is There a Business Case For Quality?

As the United States enters its ninth consecutive year of a nurse shortage, new research presented in the January-February issue of Health Affairs shows that if hospitals increased their use of registered nurses (RNs) and hours of nursing care per patient, more than 6,700 patient deaths and 4 million days of care in hospitals could be avoided each year. For hospitals using both RNs and licensed practical nurses (LPNs), greater use of RNs appears to pay for itself in fewer patient deaths, reduced lengths of hospital stay, and decreased rates of complications such as urinary tract infections and pneumonia.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free in perpetuity. The January/February issue of Health Affairs was supported in part by grants from the Federation of American Hospitals, AdvaMed, America's Health Insurance Plans (AHIP), the Council on Health Care Economics and Policy, GE Healthcare, Johnson Controls, Johnson and Johnson, and MEDLINE.


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