Nursefriendly.com: Extended Care

Wednesday, January 5, 2011

I'll Never Ration. Not Me. Not I. - NYTimes.com

Opposition to health-care rationing is a little like opposition to growing up. It sounds great. It’s just not very practical.

A society’s resources are always limited. So we have to make choices about what we can afford and what we can’t. Not everyone can afford to own a vacation home — which means vacation homes are rationed. Not everyone can afford to live in towns with excellent public schools — which means that good public education is rationed.

Similarly, we can’t afford to try every feasible medical treatment on every patient. Instead, we make choices. The most obvious form of rationing is the millions of Americans who lack health insurance today. Most of them get less medical care than they need and, in the process, keep down the nation’s total medical bill.

But even those with health insurance experience rationing. How? In many ways.

This country has not spent the money to install computerized medical records, and we suffer more medical errors than many other countries. We underpay primary care doctors, relative to specialists, and we’re left stewing in waiting rooms while our primary-care doctors try to see as many patients as possible. Specialists are usually not paid for time they spend collaborating with doctors in other specialties, and many hard-to-diagnose conditions go untreated. Nurses are usually not paid to counsel people on how to improve their diets or remember to take their pills, and manageable cases of diabetes and heart disease become fatal.

via economix.blogs.nytimes.com

At some point we'll need to accept the fact that we cannot all have every test, every operation, every treatment, every new medicine or see every specialist.

To read the rest of the article, click on the link above:

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Sunday, December 26, 2010

Guides help recovering patients find long-term care | The Salt Lake Tribune

An uncomfortable truth for anyone facing disability for a year or more: If you go into a nursing home, you might never get out.

Under patchwork Medicare provisions, says Utah Commission on Aging Director Maureen Henry, it is more convenient for hospitals to discharge patients to nursing homes than to figure out how they might live in their homes and communities.

But what looks like the easy solution can be costly. Nursing home bills may drive more people onto Medicaid, which costs taxpayers more, and the move can unnecessarily disrupt the community and impoverish the lives of patients, Henry says.

“You’re shifting residence; you’re shifting family structure out of the community and into the nursing facility,” she says.

Now, with the help of a $700,000 grant from the federal Administration on Aging, the Utah commission is linking hospital discharge staff with “options planners,” who help guide patients and their families through a complicated array of choices for extended care.

The way Medicare and Medicaid law works, people are guaranteed care in nursing homes. But there is no similar guarantee of coverage for care outside an institution, meaning family finances may limit the choices.

“People have the right to decide where and when they receive long-term care,” Henry says. “Our objective is to try to catch people before they are scrambling in a crisis, stop giving people the runaround.”

via sltrib.com