Hospitalization – Too Often the Wrong Treatment
January 15, 2009 – 7:13 am
Doctors and hospitals are made for each other. Literally. It’s a relationship at the basis of which is mutual need: A physician needs a place to send sick patients, and a hospital needs sick patients to fill beds. Voilà! A deal is struck, and the partnership continues along its usually beneficial course—lucrative for the hospital, lucrative for the doctor. But what about the consumer? Far from a financially gainful proposition, hospitalization has the potential to push the consumer to the brink of bankruptcy, and even beyond.
Most of the money spent on health care in the United States is spent in hospitals—some $200-plus billion a year. So it stands to reason that a close scrutiny of the entire process, from preadmission talks with your doctor, to admission, and on to discharge, has the potential to save your money, and probably large amounts of it. The rule of thumb here is don’t go unless absolutely necessary. Start the critical process with your doctor, and question, question, question.
What you need to consider before you and your doctor agree to schedule a hospital stay is whether hospitalization is really required for your situation. Some of the questions you asked before going to the specialist—what do you hope to find? Do the advantages outweigh the risks?—can be asked in deciding whether your ailment needs to be treated in a hospital. But at the very least, be sure to ask your doctor five basic questions before you consent to enter the hospital: Why am I going? What will be done? How long will I stay? What will it produce? What will happen if I don’t go?
Remember, just because your doctor says you belong in the hospital doesn’t mean you positively do. Many hospitalized patients should not be in the hospital at all. In a survey of the records of more than seven thousand Medicare patients, the Office of the Inspector General of the Department of Health and Human Services found that more than one out of every ten Medicare hospital admissions is unnecessary.
Another significant study—this one an eight-year project reported in the November 13, 1986 issue of the New England Journal of Medicine—pinpointed the numbers of inappropriate, avoidable, and unnecessary hospitalizations of nonelderly adults: an astounding 40 percent. Of that percentage some 23 percent were totally avoidable, and another 17 percent could have been avoided by the use of ambulatory, or outpatient, surgery.
An article in the Medical Tribune of June 15, 1989, related more evidence of overadmission, the setting in this case being the cardiac care unit, or CCU. According to the article, approximately half of the 1.5 million people admitted to CCUs annually in this country do not have “acute cardiac ischemia” (sudden onset of blockage or cutoff of blood flow, and thus oxygen, to the heart—a condition that necessitates the kind of intensive cardiac care found in CCUs). “For each such ‘lucky’ patient,” the article said, “who does not have a myocardial infarction [heart attack], the CCU tab amounts to nearly $4,000. This adds up to $3 billion spent annually to rule out [heart attacks].”
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