Bumper ball

patients like hospital care at home, but some insurers are skeptical

by:Powerful Toys     2019-09-06
During the week leading up to Christmas, Felice Petruzelli struggled to breathe.
When she went to the emergency room in December
The 26-year-old doctor at Brigham and Women\'s Faulkner Hospital said she had pneumonia and needed hospital treatment.
Then the doctor put forward something that made Petrucelli nervous: she could go home and ask the hospital to come to her instead of being taken to the hospital. As a \"hospital-at-
Petruzzelli learned that she would get home visits from doctors and nurses who would come twice a day for any necessary tests or blood tests.
A wireless patch larger than the index finger would stick on her skin, track her vital signs and send a steady stream of data to the hospital.
She can talk face to face if she has any questionsto-
Feel free to meet face-to-face with a hospital nurse or doctor via video chat.
The hospital is an old and noisy place. the patient is seriously ill, weak, and has risks of infection, insomnia and coma.
\"Your resistance is very low,\" the doctor told Petruzelli . \" Petruzelli will be 71 this week.
\"You don\'t know what will happen if you come to the hospital.
You\'re the perfect person for this.
So Petruzzelli agreed.
That afternoon, she went home in a hospital car.
A doctor and nurse waited at the front door.
She sat on the sofa in the living room with her husband Auggie and dog Max.
The doctor and nurse examined her IV and posted the monitoring patch to her chest and left. When Dr.
David Levin arrived the next morning and he asked her why she was walking around at night.
Petruzzelli said that her night trip to the bathroom was monitored, \"I feel very safe and safe,\" which was not uncomfortable.
\"What if I fell down when my husband went out to get me food? They\'d know.
After three days of calm, she was \"discharged\" from her hospital treatment at home and the equipment was removed from her home.
\"I will do this again in my heartbeat,\" said Petruzzelli . \".
Brigham Health in Boston is one of a slow-growing health system that encourages select emergency department patients who are in serious, but stable condition and do not require intensive, comprehensivethe-
Choose the clock care of the Hospital-
Level care at home.
Levin said that in the years following the start of testing such care at the Brigham and Women\'s hospitals, hospital staff who initially had a skeptical attitude generally received such care.
\"They quickly realized that this was what the patient really wanted and it was very good care,\" he said . \".
This approach is common in Australia, the UK, and Canada, but is facing a tough battle in the United States.
Clinicians and policy analysts agree that a key hurdle is getting Medicare to pay for it. The system of the medical insurance company is not usually used to pay for the hospital care provided by the family.
At Brigham Health, the hospital can charge the insurance company for a doctor\'s phone call, but the rest of the Hospital-at-
Levine said family services are covered by grants and funding from the partner Healthcare Center\'s Population Health Center, which is affiliated with Brigham Health.
The medical insurance company has no position on the hospital. at-
Catherine Donaldson, spokeswoman for the industry trade organization\'s US health insurance program, said the family program.
\"In general, Medicare providers are committed to ensuring that patients get the care they need and that there is a Medicare Advantage program that can cover this type of-
Donaldson said in a statement.
Levin, a clinician-
A researcher at the Brigham and Women\'s Hospital and a lecturer at Harvard Medical School were the lead authors of a study published last month, the study reported a small, randomized, controlled trial comparing health care use, experience, and cost in patients with Brigham who received hospital treatment
Primary care at home or hospital in 2016.
One of the 20 patients analyzed in the trial has several conditions, including infection, heart failure, chronic blocked lung disease, or asthma.
The test found that although there were no adverse events at home --
Care for patients, their cost of treatment is significantly reduced
About half of the patients treated in hospitals. Why?
First, the labor cost of-
Family patients are lower than patients in the hospital, and there must be 24/7 staff in the hospital. Home-
Laboratory tests and expert visits for nursing patients were also less.
The study found that two groups of patients were about as satisfied with their care, but the family
More physical activity in the care group.
Brigham Health is conducting further randomized controlled trials to test-
Family Models for wider diagnosis. Dr.
Professor of Medicine, Bruce Loff, director of the Center for change of geriatric medicine at Johns Hopkins Medical School, began to explore the Hospital --at-
Home concept more than 20 years ago.
His early studies were carried out in the Veterans Affairs Department Medical Center and Medicare Advantage programs that found fewer complications at home, better results and lower costscare patients.
Leff\'s study found that caregivers reported less stress.
For caregivers, travel to an unfamiliar hospital, look for and pay for parking fees, and try to schedule bedside meeting times with clinical staff --
Always worried about the health of the loved ones
Health care researchers point out that they are wearing it.
However, get used to the traditional \"head-and-
Emphasis on filling the \"bed\" model of hospital beds with bricksand-
Mortar facilities have been slow to accept change.
There are also some practical obstacles.
\"It\'s easier to ship Chinese food in New York than to ship oxygen at home,\" Leff said . \".
Starting at Mount Sinai 7.
Hospital system start-up hospital-at-
In 2014, more than 700 patients chose home instead of hospital care in family programs in New York City.
Patients can refer to the program from the selected emergency department as well as some Sinai primary care practices and emergency care centers;
The patient performed well in some measures.
The average length of hospital stay in acute care was 5 days.
3 days to 3 days in the hospital.
1 day at home-
Nursing patients while 30-
Family day re-admission rate-
Hospitalized patients account for half of the total number of hospital patients.
8% to 16
Two people 3%
Annual period as at December 2016.
From three. year, $9.
In 2014, Mount Sinai\'s project received a 6 million grant from the federal Center for Medicare and Medicaid Innovation, initially focusing on Medicare patients with six diseases, including heart failure, pneumonia
Since then, the project has expanded to include dozens of conditions --
Including asthma, high blood pressure and severe infections like honeycomb inflammation
Now, some patients with private insurance and people with Medicaid are available.
The health system also works with Contessa health, a company with expertise in home care, to negotiate contracts with insurance companies to pay for hospitalsat-home services.
Among other things, insurance companies are worried about what it means to be hospitalized, Dr.
Linda De Herry, clinical director of the Sinai medical system mobile acute care team. \"[Insurers]
If the patient is really not going to be hospitalized in the first place, I don\'t want to pay for the admission, \"said de Herry.
Kaiser Health News is an independent news service for editors and is a non-partisan Henry J.
Kaiser Family Foundation
Follow Michelle Andrews on Twitter: @ mandrews110.
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