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SEPTEMBER 7, 2012
MEDICINE:
Pass Fail? The home game O
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nce upon a time, the list of medical events that could land someone in the hospital for an extended stay was about as long as, well, most hospital stays back then. Having a baby or just about any surgical procedure, including an appendectomy or tonsillectomy could easily mean a week in the hospital, often more. For more serious situations patients could routinely expect a month in the hospital followed by extended at-home care. That, as they say, was then. Now, the same procedures that put patients flat on their backs with aroundthe-clock medical care in olden times (meaning as little as ten or twenty years ago) might very well be an outpatient procedure today. That means you’re going home immediately afterward. Another aspect of this issue: the hospital stays of yore also began earlier. While a patient today might be told to report to the hospital at some godforsaken pre-dawn hour on the day of surgery, back in the day that patient might have checked in the day before (or earlier). Is that a bad thing? In some ways yes, in other ways it’s one giant leap for mankind, as the late great Neil Armstrong would have said.
he article about laws relating to passing stopped school buses in
our last issue prompted several readers to ask about funeral processions. Is it legal to pass a funeral or not? We turned to law enforcement for the official answers, and they’re inside.
When you... We...
What’s good about it? On the simplest, most humanistic level, most of us would rather be at home in our own comfortable surroundings than in a hospital room. That presumes, of course, that we can have our cake and eat it, too, that being at home will not compromise our return to normal activities. Read on for more about that.
When we’re at home, it’s a safe bet a total stranger will not clatter into our bedroom at 3:00 a.m. to check vitals. Gotta love that. On a more practical, nuts-and-bolts level, outpatient procedures and early discharges save money. Some people might view that as a negative: “My care has been short-changed because they sent me home to save money. Save money? For who? They sent me a bill for fifty thousand dollars!” Hold on. Calm down. You’re going to bust your stitches wide open. First of all, you should have asked, “For whom?” Who is a nominative pronoun and... well, never mind... Pronouns aside, when insurance companies spend money, insurance rates go up for everybody. Nobody wants that. When they save money, it ultimately saves money for all of us. Everybody wants that. Secondly, when a hospital saves money it can do all kinds of good things: protect jobs, enable upgrades to and purchases of expensive medical equipment, and yes, also keep our money in our collective pockets. Shortened hospital stays (and the dollars they save) are not dollar-driven decisions. That’s just one contributing factor. A hospital could save tons of money by sending a patient home the same day they get a lung transplant, but you’ll never see that happen. Shortened stays are first and foremost decided from the standpoint of patient outcomes. No hospital is going to leave itself wide open to malpractice litigation due to a reckless discharge policy. Despite the benefits, for patients there are some definite and serious drawbacks
THE SKINNY ON HEALING THYSELF • Why is there a growing outpatient trend? Among the reasons: • advancements in surgery, including laparoscopies and other less invasive procedures that reduce time in surgery, minimize blood loss and decrease operative and post-op complications • improvements in anesthesia allowing faster recovery • better pain medicines • cost-saving efforts by hospitals and insurance companies
• Underscoring the rise of outpatient medicine, the Wall Street Journal reports that there were just 240 freestanding outpatient surgery centers nationwide in 1983; there were more than 5,000 in 2010 (including several in Augusta). • A federal study says the mean cost of all inpatient surgeries is about $40,000 versus a mean $6,000 pricetag for all outpatient surgeries. • 65% of all surgeries required an overnight hospital stay in 1980; only 16% did in 2010. In the same timeframe the average hospital stay has dropped from about two weeks to about three Please see HOME GAME page 16 days. +
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