Dramatic Increase of Patients Going from Hospitals to Home Care

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    The number of patients who needed home health care after being discharged from hospitals surged by about 70 percent (2.3 million to 4 million) from 1997 to 2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).

    In contrast, the number of patients routinely discharged to their homes without the need for additional care grew by less than 8 percent, from 27 million to 29 million patients, during the period.

    The Federal agency also found that during the period between 1997 and 2008:

    • Some 5 million hospital patients were discharged to nursing homes and other long-term care facilities—an increase of 35 percent (from 3.7 million to 5 million).
    • There was a 40 percent increase in the number of patients (264,000 to 370,000) who left the hospital against medical advice.
    • Hospitals transferred an additional 4 percent of patients to other hospitals (846,000 to 878,000).
    • Fewer patients died in the hospital—a decrease of 5 percent (from 852,000 to 811,000).

    This AHRQ News and Numbers summary is based on Exhibit 1.5 in HCUP Facts and Figures 2008, which provides highlights of the latest data from the 2008 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project (HCUP).


    source: http://www.ahrq.gov/news/nn/nn030911.htm
    Last edit by brian on Mar 15, '11
    lindarn likes this.
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  3. 7 Comments so far...

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    Would all of the above statistics have something to do with money?
    Home health agencies obviously prospered during this time. Who controlled the home health industry? What interest does the MD and hospitals have to discharge pts to nursing homes instead of to home with family? Yes, families make those choices, but how many of us have seen MDs lean on families to take the nursing home option.
    Pt's signing out AMA. Why would a sick person leave the hospital if they're still sick? Stupid? Crazy? Seeker who had their supply cut off? Or a responsible human being who was worried about paying the enormous bill, and left because they knew they couldn't. The poor economy and loss of health insusrance would coincide with the statistics.
    I'm such a suspicious person. When it comes to health care it's all about money.
    TheChair1, IowaKaren, Psychtrish39, and 5 others like this.
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    Could it also be, that home health care is far less costly than nursing home care and cost-conscious patients and families were more likely to choose recovery at home with home care versus going into a nursing home? My second hypothesis is that it's a result of older, sicker patient populations requiring more complex care during recovery and thus requiring in-home support.
    VickyRN, KristeyK, dudette10, and 3 others like this.
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    I left a hospital against medical advice last year.... looked up how much radiation the recommended mri would give (on our lap top) and decided even that much was a bigger risk than the odds of missing something by not having the mri. That wasn't even considering any financial costs. The doctor understood my point but said the standard of care was to get the mri when the first test came back negative therefore, I would have to sign the "against medical advice" paper.

    When there is as much "cover your butt" in the medical advice given as there is these days, then people start factoring that into their decisions.
    IowaKaren and cherryames1949 like this.
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    I've worked in home care and IMO they are sending the patients home too early or without proper medications. I can't count the number of times I've sent a patient back to the ER b/c they were discharged with no DVT prophylaxis after surgery or are engorged with fluid practically coming out their ears with cardiac issues! We can do a lot with home care but we don't do EKGs, cardiac caths, ultrasounds, or instantaneous IV infusions (those take a while to get from pharmacy, esp in rural areas). I think home care is being substituted for what used to be the last 2-3 days in the hospital less-acute unit.
    fosmom8, IowaKaren, Psychtrish39, and 14 others like this.
  8. 0
    You just said a mouthfull RNvampire!
  9. 3
    I'm not an RN yet, but I used to work for a DME company that set up EVERYTHING for work comp. patients. I completely agree with RNVampire. It amazed me at the condition these people would get sent home in. Sometimes they'd even d/c someone with, say, a double amputation before they even sent me orders for a wheelchair or ANY assistive devices, much less having nursing care or pharmacy/medical supplies ordered. UGH!!! It didn't happen to everyone, but it still happened more than I STILL care to believe. :-/
  10. 0
    Quote from Saysfaa
    I left a hospital against medical advice last year.... looked up how much radiation the recommended mri would give (on our lap top) and decided even that much was a bigger risk than the odds of missing something by not having the mri. That wasn't even considering any financial costs. The doctor understood my point but said the standard of care was to get the mri when the first test came back negative therefore, I would have to sign the "against medical advice" paper.

    When there is as much "cover your butt" in the medical advice given as there is these days, then people start factoring that into their decisions.
    MRI has ZERO ionizing radiation, and ZERO exposure risk. ZERO. I'd have left AMA just because any provider who let you believe otherwise is incompetent.


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