"If avian flu occurred in the U.S., a large financial loss would probably be borne by the treating institution unless the government offsets losses not covered by insurance," Romeis says. "We may be reasonably well prepared to respond to the clinical aspects of the epidemic, but may be inadequately prepared for the economic and operational impact.
"What will not be reimbursed is the lost business at hospitals, and those indirect losses can be enormous."
Romeis made his observations based on the impact of SARS, another infectious disease, on the Taiwanese health care system in 2002-2003. He found that patients there delayed care, postponed elective procedures and stayed away from the emergency rooms of hospitals known to treat SARS patients because they were afraid of contracting the disease.
"For instance, during the peak of the SARS crisis, the National Taiwan University Hospital's number of surgeries dropped from 3,576 in May 2002 to 519 in May 2003, an astonishing decrease rate of 85 percent," he said. "At one point early in the epidemic, the hospital temporarily closed down its emergency room."
Without national government reimbursement, the hospitals would have lost millions of dollars related to decreases in hospital utilization, he says.
Romeis has studied the Taiwanese health care system for the last decade and is the author of a book chapter that includes information about the impact of SARS on Taiwanese hospitals.
The book, International Health Care Management, was published this year by Elsevier Ltd. Coauthors of the chapter are Shuen-Zen Liu, professor of accounting at National Taiwan University School of Business, and Michael A. Counte, Ph.D., professor of health management and policy at Saint Louis University School of Public Health.
Saint Louis University School of Public Health is one of only 37 fully accredited schools of public health in the United States and the nation's only School of Public Health sponsored by a Jesuit university. It offers masters degrees (MPH, MHA and MS) and doctoral programs (Ph.D.) in six public health disciplines and joint degrees with the Doisy College of Health Sciences and Schools of Business, Law, Medicine and Social Service. It is home to seven nationally recognized research centers and laboratories with funding sources that include the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the American Cancer Society, the Robert Wood Johnson Foundation and the World Health Organization.