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January 22, 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.

Coverage Expansions: The Urban Institute’s Sharon Long, Stephen Zuckerman , and John Graves present a new study on public health insurance expansions.

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.

Consumer-Driven Plans: New research presented in the January-February issue of Health Affairs on hospitals use of registered nurses (RNs).

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

Are Adults Benefiting from State Coverage Expansions?

Public health insurance expansions for low-income adults boosted overall coverage rates for parents in Wisconsin and parents and childless adults in Massachusetts. However, in New Jersey and California, expanded public coverage displaced existing private insurance and produced little evidence of an overall gain in coverage. So says a new study by the Urban Institute’s Sharon Long, Stephen Zuckerman , and John Graves, published Jan. 17 on the Health Affairs Web site.

Specialty Hospitals: A Problem Or A Symptom?

In the January/February Health Affairs, Stuart Guterman tells us that specialty hospitals are the canary in the coal mine, alerting us to systemic problems in our health care system. By skimming off more profitable, less complex cases, specialty hospitals alert us to discrepancies in our reimbursement systems; by avoiding the uninsured and underinsured, these facilities highlight the absence of adequate reimbursement for providers that do treat vulnerable populations. The problem, says Guterman, is that we have passively watched canaries dropping dead for years, revealing these very systemic flaws, and he questions whether we will have the will to respond to the demise of this latest canary. Print editions of the January/February issue on “U.S. Hospitals: Mission Vs. Market” may be ordered for $35 each from Health Affairs’ Customer Service at 301-347-3900 or online at

Impact of Consumer-Driven Insurance Plans On Hospitals

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. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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