When I had my eye injury several years ago, I was under the umbrella of my dad's insurance. It was good coverage, and was even better if used at the hospital where he worked - which it was. With good coverage comes good payment to the hospital and the physicians. So, naturally, I was admitted to the hospital for about two and a half days after a fairly simple corneal laceration. And it's not like transportation would have been an issue for daily follow up - we lived maybe five miles away.
Since becoming an ophthalmology resident, things seem to have changed immensely. Whenever we see globe trauma, no matter what hour of the night, the patient is taken to the OR, repaired, and then sent right home. The patient sometimes earns an observation admission if the repair is going to be delayed several hours for some reason. The only other time a hospital admission occurs is if there are other injuries and the patient isn't even on our service. A rare exception might be if the patient lives far away and/or is not likely to follow up as asked.
First of all, most of our patients don't have insurance. They would never pay a hospital bill, and aren't likely to pay the emergency room and operating fees. So that would just be pure lost money. Secondly, perhaps in the growing realization of poor cost effectiveness practice in most of medicine today, we have realized that such hospital admissions are not necessary. If not downright fraudulent in the case of a well-insured patient.
No comments:
Post a Comment