Quality Of Care

Officials seeking a partner for Howard County General Hospital say they have eliminated a for-profit suitor, easing the concerns of many in the community.In their first large public meeting on the search for a larger health care conglomerate, the hospital's two main leaders -- Alton J. Scavo, chairman of the board and Victor A. Broccolino, president -- spoke to more than 100 community leaders, residents and hospital staff members Saturday at the county's Board of Education headquarters."We are narrowing it down to two institutions, and I can tell you that a for-profit entity is not an alternative," said Scavo, who noted there are now three contenders.

YOUR MARCH 20 editorial, "Curbing the power of HMOs," contained a number of factual errors. The most blatant one was your assertion that "medical decisions are made not by physicians . . . but by bean-counters. . . ."I have been a sole practitioner for 25 years in Columbia. My specialty is family practice and I belong to several HMOs (over two-thirds of my patients are members of HMOs).I have never been told how to practice medicine by any HMO.I have been given practice guidelines on selected diseases (like asthma and heart failure)

MOSCOW -- Dr. Mikhail Alshibaya, one of Russia's leading heart surgeons, has mixed emotions about President Boris N. Yeltsin's decision to have a bypass operation in Russia at the end of this month.Alshibaya says the president's decision was "the best advertisement we could get" for bypass surgery, an uncommon operation in Russia.But he says it probably would be safer for the president to go to the West for the operation.Heart disease is the leading cause of death in Russia, as it is in the United States.

WASHINGTON -- In a move that will help consumers and employers compare the quality of health plans, an industry group yesterday released a report that places the Columbia Medical Plan among the top five for "quality of care" in the country.Using data available to the public for the first time, the report measures plans' performance in dozens of ways such as the percentage of immunized children, the rate of births by Caesarean section and the percentage of doctors who are accepting new patients.

Defining the Gray Area of Medical PracticePerhaps It is coincidence, but the three articles on the front page and the Perspective section May 14 certainly point up the increasing attention- to HMOs.It is instructive to note that while HMOs, in fact if not in name, were in existence long before, the big push behind their creation today was in the 1960s and 1970s.Those leading the effort, almost a crusade, were the idealistic physicians and health economists who believed in the HMO concept, the emphases on preventive care for a fixed amount of prepaid dollars, as a more rational system for delivering both - quality and cost effective care.

She's cradling Grace, a 10-month-old baby, in her arms in a motherly embrace that spells love. That's because she loves Grace. The baby has the blackest of silky straight hair and matching long eyelashes combined with a sweet, sweet smile.The rocking chair rocks, but only slightly. Grace is cocooned in a soft white blanket.The young woman who rocks her, kisses her lightly on the head and talks gently to us while we watch -- she is not Grace's mother. She is Cathy, a primary care-giver in the infant rooms of the Downtown Baltimore Children's Centers (DBCC)

A study of doctors and clinics that care for many Medicaid patients in Maryland has found that the lowest-cost providers are not necessarily the worst, nor are the most expensive the best.When it comes to the overall health of patients, researchers at the Johns Hopkins School of Hygiene and Public Health and the state health department found that there was really no relationship between cost and quality of care.The findings suggest that policy-makers don't have to compromise care in their zeal to trim expenses -- as long as they monitor the work done by providers.

It may seem that officials at Howard County General Hospital are putting the cart before the horse with plans to reorganize departments and increase staff workloads. The effort is aimed at cutting costs at a time when the hospital is facing increased competition from health maintenance organizations, private health insurers and outpatient clinics. The changes will go into effect even though the hospital doesn't plan to hire a consulting firm thoroughly to analyze its patient care and purchasing procedures until February.

BLUE BELL, Pa. -- For months, Americans nervously watched Washington try to overhaul the nation's health care system. They should have been looking to Blue Bell instead.This southeast Pennsylvania town is the home of U.S. Healthcare, a leader in a revolution that is shattering the traditional relationship between doctor and patient.If you don't belong to U.S. Healthcare or another health maintenance organization, odds are that you will someday. Already, more than 45 million Americans, including 1.4 million Marylanders, get their health care through HMOs.

Reports on GunsThe misleading news reports in The Sun and the malicious cartoons by Kal, Mike Smith and Mike Lane gave your readers the erroneous impression that the only reason a majority of the members of the House of Representatives voted against the president's crime bill the first time was the ban on assault weapons.This was not true. There were many provisions in the bill which were found to be unacceptable. As appears in your Aug. 22 edition, the bill passed the House only after a number of appropriate amendments were made strengthening its anti-crime provisions while retaining the ban on assault weapons.