About ACHE What New Affiliate Directory My ACHE Affiliates Log In Corporate Partners
ACHE Home
Welcome to ache.org Welcome to ache.org
Join ACHE Credentialing Education Chapters Career Services Books & Journals Reasearch
Research
 
  Research Links:
 
  Research Publications

Top Issues Confronting Hospitals: 2008

View the 2008 Top Issues press release.

Financial challenges continued to rank No. 1 on the list of hospital CEOs’ top concerns in 2008, with patient safety and quality their second most prominent concerns, according to the American College of Healthcare Executives’ (ACHE) annual survey of top issues confronting hospital CEOs. “While CEOs’ concerns surrounding financial challenges are heightened, given the economic downturn, their commitment to creating and implementing systems to improve quality and patient safety in our nation’s hospitals is their second most prominent concern,” says Thomas C. Dolan, PhD, FACHE, CAE, president and CEO of ACHE.

In the survey, ACHE asked respondents to rank 12 issues affecting their hospital in order of importance and to identify specific areas of concern within their top three issues. Following are some key results from the survey, which was sent to 1,092 hospital CEOs in October 2008 of whom 433, or 40 percent, responded.

Each of the issues in the following table is listed by the percentage of respondents who indicated it as one of the top three issues confronting their hospital. In 2008, 77 percent of respondents cited financial challenges as one of their top three concerns, reflecting an increase from 70 percent in 2007. Forty-three percent of hospital CEOs identified patient safety and quality as a major concern. In prior years these issues were listed separately, so no direct comparison is possible.

Care for the uninsured continues to rank as hospital CEOs’ No. 3 issue, with 41 percent of respondents citing it as a major concern. In 2008 there was increased mention by respondents of governmental mandates (26 percent), patient satisfaction (22 percent) and capacity issues (16 percent) as other top concerns.

Issue 2008 2007 2006
Financial challenges 77% 70% 72%
Patient safety and quality 43% NA NA
Care for the uninsured 41% 38% 37%
Physician/hospital relations 32% 35% 40%
Personnel shortages 30% 30% 30%
Governmental mandates 26% 22% 23%
Patient satisfaction 22% 17% 16%
Capacity 16% 11% 11%
Technology 9% 8% 8%
Issues about not-for-profit status 2% 4% 3%
Malpractice insurance 2% 2% 2%
Disaster preparedness 1% 1% 12%
Patient safety NA 29% 27%
Quality NA 33% 29%

Within each of their three top issues, respondents identified specific concerns facing their hospital. Following are those concerns in order of importance for the top three issues identified in the survey:

Financial Challenges

Medicaid reimbursement 83%
Bad debt 78%
Increasing costs for staff, supplies, etc. 75%
Medicare reimbursement 73%
Inadequate funding for capital improvements 63%
Managed care payments 46%
Other commercial insurance reimbursement 40%
Revenue cycle management 40%
Emergency Department 36%
Competition from specialty hospitals 20%
Other 9%

Patient Safety and Quality

Redesigning care processes 66%
Redesigning work environment to reduce errors 66%
Compliance with accrediting organizations 60%
Medication errors 57%
Nosocomial infections 47%
Nonpayment for “never events” 43%
Pay for performance 41%
Leapfrog demands 40%
Public reporting of outcomes data 40%
Surgical mistakes 24%
Other 7%

Care for the Uninsured

Medicaid 87%
Advocacy for funding 75%
Underwriting costs 61%
Reaching out to all community members 27%
Other 20%
Response to other hospital closings 10%
   
 

HOME | SITE MAP | LOG IN    FAQ | Update Your Information | Contact Us | Refer a Colleague
ACHE Copyright, Disclaimer and Privacy Notice