Closure dismays delivery nurses
St. Vincent asked to explain move
The announced closure of CHI St. Vincent Infirmary’s labor and delivery unit has angered nurses at the Little Rock hospital, who want answers about that decision’s rationale, a union representative said Tuesday.
Registered nurse Paige Yates, who is president of the Office and Professional Employees International Union’s local chapter, works on the unit and has been with the hospital for more than 23 years. She said staff members were notified of plans to end labor, delivery and neonatal intensive care services at a meeting Dec. 5 after hearing rumors of the transition from a nurse who works both at the hospital and at UAMS Medical Center.
“Of course there was outrage,” she said. “We had no idea it was coming. … It was very strange, and very upsetting for all of our staff and our physicians.”
Staff members have been agitated both by the move’s timeline, which recently shifted from March to early February, and what a news release from the union describes as “conflicting reasons” from the administration about the closure. Yates said an explanation that labor and delivery services are already well-serviced in the area doesn’t make sense
Rising costs of prescription drugs have strained hospital budgets and operations, forcing health systems to cut costs by reducing staff, a new study found.
Hospital drug spending increased by 18.5 percent between 2015 and 2017, a rate far exceeding medical inflation for the period, according to a report prepared for three health associations by the National Opinion Research Center at the University of Chicago. U.S. community hospitals spent an average of $555.40 on prescription drugs for each admitted patient in 2017.
“We are in the midst of a prescription drug spending crisis that threatens patient access to care and hospitals’ and health systems’ ability to provide the highest quality of care,” said Rick Pollack, chief executive officer of the American Hospital Association, which commissioned the report along with the Federation of American Hospitals and the American Society of Health-System Pharmacists.
Drugs associated with outpatient care, which includes emergency room visits and other short-term services, were the most costly. Outpatient drug spending increased 28.7 percent per admission, while inpatient spending grew by 9.6 percent. Price increases that affected hospitals were seen across various classes of drugs, including anesthetics, non-oral solutions and chemotherapy.
The main drivers of the increases were high list prices set by drugmakers, coupled with ongoing shortages for critical treatments, according to the research center’s data analysis of more than 4,200 U.S. hospitals.
The report comes as pharmaceutical companies are under increasing pressure from President Donald Trump’s administration, Congress and insurance companies over rising drug costs. Last week, Trump summoned his top health officials to the White House to discuss the increases, while lashing out at drugmakers on Twitter.
Drug shortages are also contributing to rising costs. As common drugs such as saline solutions and generic injectables are increasingly difficult to obtain, many have shot up in price, according to the study. However, those drugs often don’t see prices fall to the original level after a new supply floods the market.
“Price increases and drug shortages are the two biggest pain points for hospitals and have been for several years,” said Erin Fox, senior director of pharmacy at University of Utah Health, who monitors drug shortages and assisted with the report.
The number of drugs in short supply in the U.S. has skyrocketed since 2017, when there were 146 shortages, according to the American Society of Health-System Pharmacists. Already, the group has identified 250 shortages in 2018 — and Fox and her colleagues are still counting.
The effect of drug price increases and shortages has reverberated throughout health systems. More than 9 in 10 hospitals identified alternative therapies to mitigate budget pressures associated with changing drug prices, while 1 in 4 hospitals went as far as cutting staff to curb costs, according to the report. Hospitals are also delaying internal investments and conducting more in-house compounding.
Health systems have urged Congress and the U.S. Food and Drug Administration to act. In a Friday letter to FDA Commissioner Scott Gottlieb, who oversees a drug shortage task force, the American Hospital Association recommended that manufacturers face more severe drug-shortage disclosure requirements and be fined should they fail to comply.