Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

Urgent Care Centers: Lower-Cost Than Emergency Departments, but They Increase Spending

Apr. 26, 2021

The rapid expansion of Urgent Care Centers (UCC) over the past decade has raised the tantalizing possibility that UCCs could be a cost-effective alternative for visits that do not need the full capabilities of an emergency department (ED). On the surface, this seems to make sense. In our new study in Health Affairs, the average UCC visit cost only $171 compared to the staggering $1,646 for an ED visit.

Delayed Emergencies in COVID

Mar. 4, 2021

COVID-19 changed every aspect of our lives, from shopping for groceries to visiting doctors. Early public health messages encouraged people who thought they could put off emergency care to avoid the emergency department (ED), to save capacity for an anticipated surge of COVID cases.

Expanding Scope of Practice After COVID-19

Feb. 15, 2021

To expand access to health care during the COVID-19 pandemic, many states relaxed or waived regulations that define the scope of health professional practice. This experience highlights the need to ensure that all health care professionals practice to the full extent of their capabilities—an issue that predates and will outlast the pandemic. In a virtual conference on November 20, 2020, Penn LDI and Penn Nursing brought together experts in law, economics, nursing, medicine, and dentistry to discuss current gaps in health professional scope of practice, what we have learned from COVID-19, and how to rethink scope of practice to better meet community and public health needs.

Post-Acute Stays in Skilled Nursing Facilities: Patient Experiences

Feb. 10, 2021

What kind of care do patients expect after they are discharged from a hospital to a skilled nursing facility (SNF)? And how do those expectations align with care they actually receive from physicians and advanced practitioners? We know surprisingly little about the patient care experience in these post-acute settings, even though 1.5 million people in the U.S. are discharged to them each year. One fourth of those people die or are readmitted to the hospital within 30 days.

Police Transport of Injured People to Trauma Centers in Philadelphia

Feb. 9, 2021

Through a policy known as “scoop and run,” Philadelphia police play an integral and growing role in the emergency medical transport of victims of the city’s gun violence epidemic. Blood loss is the most critical threat to survival after a serious penetrating wound. Rapid transport to a nearby trauma center by police can be life-saving.

Pennsylvania Scope of Practice Policy Brief

Jan. 28, 2021

Pennsylvania is one of 28 states that has not expanded the scope of practice in its licensure laws for certified registered nurse practitioners (NPs), who must maintain formal collaborative agreements with physicians to practice. For many years, proposals to update licensure and adapt it to make it more compatible with current models of collaborative care could not overcome legislative logjams. Recognizing an opportunity to break the logjam, the University of Pennsylvania held a virtual workshop on November 20, 2020, bringing together researchers, health professionals, and consumers to chart a new path forward. This policy brief summarizes their recommendations to update scope of practice regulation to better meet the primary care needs of Pennsylvanians.

The Cost of Quarantine: Projecting the Financial Impact of Canceled Elective Surgery on the Nation’s Hospitals

Jan. 22, 2021

Sourav K. Bose, Serena Dasani, Sanford E. Roberts, Chris Wirtalla, Ronald P. DeMatteo, Gerard M. Doherty, Rachel R. Kelz

Abstract [from journal]

Objective: We sought to quantify the financial impact of elective surgery cancellations in the United States (US) during COVID-19 and simulate hospitals' recovery times from a single period of surgery cessation.

Background: COVID-19 in the United States (US) resulted in cessation of elective surgery-a substantial driver of hospital revenue-and placed patients at risk and hospitals under financial stress. We sought to quantify the financial impact of elective surgery