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Are hospitals putting themselves out of a job?

Some hospital leaders call it “demand destruction.”

Some hospital leaders call it "demand destruction."

Instead of focusing only on treating people when they are seriously ill—and need to be in the hospital—hospitals are working to keep people healthy and out of the hospital. To reduce demand for intensive (and expensive) inpatient care, hospitals are working to promote a healthier population and prevent illness in the first place.

Hospitals still have a very important job to do. It's just that the nature of that job is changing and expanding.

Hospitals are making these changes because it's the right thing to do for patients and communities. And because the people who pay the bills—patients, insurers, employers, and state and federal governments—are demanding these changes in order to curb health care spending.

How are hospitals working to destroy demand?

As a start, to foster a healthier future that is less dependent on inpatient care, many hospitals are finding new ways to improve the health of our children.

That's the goal of the Center for the Urban Child at St. Christopher's Hospital for Children in Philadelphia. The Center offers one-stop shopping for a wide array of services—everything from wellness checks for newborns and breast-feeding education for new moms to farm-fresh foods, on-campus access to the Women, Infants, and Children supplemental nutrition program, routine dental care, medical specialists, injury prevention—even legal aid.

With nearly one in five of the region's children obese or overweight, many hospitals have fitness and nutrition programs for children and teens. These programs are crucial to the quality of life our children enjoy now—and key to preventing diabetes and other chronic conditions that could plague them later.

Mental and physical harm from violent words and actions is increasing among children and young adults. The Children's Hospital of Philadelphia, Temple Health, and a partnership between Drexel University and several Philadelphia hospitals have developed nationally and locally recognized initiatives to address these issues.

And initiatives like these are starting to show some promising results.

From 2006 to 2010, Philadelphia experienced a 4.7 percent decline in obesity among children in grades K through 12. An ambitious public health campaign by the City's Department of Public Health deserves most of the credit. The results prove that an effort like this can work.

The news about health care spending is good, too. Hospital prices fell 0.1 percent during January compared to a year ago, the first such decline in more than two decades.

Can we really improve health, reduce the need for inpatient care, and contain health care spending? With goals as important and as challenging as these, evidence that they are also achievable is welcome indeed.


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