Tuesday, February 19, 2008

172 Medicare no longer paying for hospital mistakes

This is a bit off topic from Alzheimer's, but not from my dad.
Medicare won't pay hospitals for errors
Almost every condition they are no longer paying for my dad had, and the combination of those conditions are what killed him.
It's a new way to push for patient safety: Don't pay hospitals when they commit certain errors.....
Even when a hospital makes a preventable error, it still can be reimbursed for the extra treatment that patient will now require. Some errors can add $10,000 to $100,000 to the cost of a patient's stay.
Or kill them. Like my dad. :(
(O)ne in four hospitalized patients is outfitted with a urinary catheter. The tubes trigger more than half a million urinary tract infections a year, the most common hospital-caused infection.
Check. My dad had a UTI caused by being catheterized for months, starting when he was tied up in that awful emergency room without food, water or medicine for all those days.
Yet many patients don't even need catheters...and many who do have them for days longer than necessary....(N)early half of hospitals don't even keep track of who gets one.
Beginning Oct. 1, Medicare no longer will pay those extra-care costs for eight preventable hospital errors, including catheter-caused urinary tract infections, injuries from falls, and leaving objects in the body after surgery. Nor can hospitals bill the injured patient for those extra costs.
My dad had everything on that list except foreign objects left in his body after surgery.
Next year, Medicare will add three more errors to the no-pay list; ventilator-caused pneumonia and drug-resistant staph infections are top candidates.
We all know that my dad died of a drug-resistant staph infection from a cathether-induced UTI, after a hospital-caused fall.
On the one hand, this idea seems great to me. Punish the hospitals for giving shitty care! But in the long run, who is going to pay for these errors? They will just raise the prices of everything. No hospital is going to "eat" all that money.
Hospitals screw up, badly, all the time. A friend of mine who is a nurse was telling me a couple of weeks ago that while she was on vacation, someone from her emergency room called to say "we just killed a guy, what do we tell the family?" They forgot a critical step in the guy's care, and by the time they figured it out and went to rectify it, he was dead. Horrifying. If I make a mistake at work, a coupon might get printed with a wrong expiration date, or someone's name is misspelled, or there's a typo in a headline. If she makes a mistake, a person can be hurt or even killed. Not a job I want to have.


Mauigirl said...

I think the idea is that if Medicare doesn't pay for the mistakes, the hospital will have to absorb the costs and perhaps it will encourage them to take better care.

Speaking of UTIs, my mother-in-law is in the hospital with one. Not from being catheterized, but I wonder whether it was from sitting around too much at the nursing home. I believe she has been wearing diapers so it could have been an irritation that caused it. She was pretty sick but is responding to the antibiotics so I'm hoping it's not a healthcare related, resistant germ.

Gail Rae said...

I'm ambivalent about this, too. Part of what I've been doing these last few weeks while my mother's been ill is making sure I don't have to take her to the hospital for ANYTHING. My mother has been the victim of hospital catherization; she's been the victim of hospital caused skin tears; she's been the victim of in-hospital verbal abuse by floor nurses; she's been the victim of ER doctor misdiagnosis (actually, covert refusal to diagnose); all of which I've written about, all of which I've reported to the hospitals in question. So far as I know, she's never contracted a staph infection at a hospital, but lately I went to great lengths to prevent this possibility by seeking out and quitting all medications she was taking for her horrible cold that may have affected her anemia. Luckily, her hemoglobin seems to be recovering on its own. I doubt that we're completely out of the woods, but my understanding is that even the hospital, here, is, at the moment, loaded with ER visitors who don't have family doctors and are seeking treatment for the flu that's hit here pretty hard (and which may be what I had and from what my mother is recovering). No way was I interested in taking her into ER to receive a blood transfusion in an environment that would be rife with intra- and extra-environmental infection, at the moment.
And, I know what you mean about ambivalence about the proposed "cure" for this deplorable condition. I agree that this country's current health care industry is ripe to pass on the costs rather than fix the problems.
I can't help but wonder if these problems are peculiar to our health care system or if they are world wide, regardless of whether a country has a single payer/all inclusive/government run health care system or a corporation dominated system like ours.