Hospital Budgeting Ethics
Hospital Budgeting Ethics
Ethics, EBM, and hospital management discuss how hospital management should use evidence base medicine (EBM) to solve ethical issues that they face daily. In 2003 when the article was written the authors say that EBM was relatively a new concept and that it would be a powerful tool to use to find solutions for the ethical issues for hospital management in the hospital setting. They also discussed the down side to using EMB. It is not always easy to deal with stake holders being hospital management, and EBM could allow stake holders to have the upper hand. Hospital management will always have ethical issues that will pertain to funding, quality of patient care, staff and issues dealing with the community. In the article it was discussed how Germany was switching over their hospital payment system to disease related group (DRG) and how EBM would be a benefit, and how hospital management would deal with the ethical issues that would arise and try to solve them.
The article clearly states that evidence base medicine would help hospital management with ethical issues in a hospital setting. The hypothesis of this article was the use of EBM was a tool that should be used to develop a more ethical foundation for hospital management. Biller-Andorno, Lenk and Leititis have defined and explained all key terms within the article so that it was easy to understand except for one important term.
Review of Literature
Biller-Andorno, Lenk and Leititis have cited sources for their article that were pertinent to the topic. The articles used were articles on evidence base medicine, ethics and hospital policy with many of these articles being published between 2000 – 2002. There were some that were published in the 1990’s. I did not find this article to broad or too narrow, the authors stayed on the topic presented. I must admit at first, I was lost when the authors presented the fact that Germany was changing their payment system I did not know how this was related to the topic. But as I read over the article again I realized that Germany was going to calculate the hospital budget on only DRGs. This could pose as an ethical issue for the hospital management because Biller-Andorno, Lenk and Leititis stated that this would lead to some hospitals that had high overhead from their emergency an intensive care units’ their resources would need to be cut. This will lead hospital managers to try to take money from other units and staff which has ethical implications cutting funds from one place and using them somewhere else.
The conclusion discussed how hospital management must address ethical issues. Biller-Andorno, Lenk and Leititis implied during the conclusion that the increase of using EBM in hospital management could become a tool used as a power struggle between hospital management and stake holders. They stated, “Will EBM be able to realise its positive potential as a useful instrument for quality management and resource allocation, or will it be used as a profit oriented “tool for excising large areas of health care expenditure”?” The ones that will be affected will be the patients, staff and the community as hospital management navigate ethical issues. The recommendations that were suggested were that ethical codes need to be established like those of the American Hospital Association. By having ethical rules in place, it would be harder for stake holders to use EBM for financial gain and it would be easier for hospital management to address the ethical issues of the hospital.
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HospitalBudget.docx
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