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Tuesday, September 23, 2014
|In the United States, there are more than 1.6 million people living in nearly 17,000 nursing homes. Every year more than 25 percent of these patients are transferred to the hospital or emergency room. The main reasons for the transfers are urinary and respiratory tract infections. Today, more and more patients are being shuttled back and forth between nursing homes and hospitals leading to a "ping-pong" pattern of treatment. There is concern that these frequent transfers may have a negative impact on the quality of care these patients receive.||Today, more and more patients are being shuttled back and forth between nursing homes and hospitals leading to a "ping-pong" pattern of treatment.|
There are many factors threatening the quality of care a nursing home patient receives. Examples are:
|The average community hospital charges Medicare $4,000 to treat a urinary tract infection.||There are benefits to reducing the number of times a patient is transferred. One benefit is reduced health care costs. The average community hospital charges Medicare $4,000 to treat a urinary tract infection. With 1.8 million nursing home beds in the US yielding more than 200,000 hospitalizations a year for infections, a $1 billon price tag results. Better management of the health problems of nursing home residents could result in significant savings.|
Ideally, when a nursing home resident is very sick, a personal health care provider, familiar with the patient, would be available to evaluate him/her in the nursing home. In a 1992 study completed in Cincinnati, Sally Brooks, M.D. concluded that physicians collect limited clinical data before deciding to transfer patients to the hospital. Studies around the country are being conducted that provide financial incentives to treat seriously ill patients in a skilled nursing facility, avoiding a trip to the hospital. This may be part of the solution that leads nursing homes and physicians to provide quality, low-cost care to patients without the inconvenience of a transfer to a new health facility.
Last Reviewed: Apr 10, 2006
Gregg Warshaw, MD
Director, Office of Geriatric Medicine
College of Medicine
University of Cincinnati