Tuesday, September 23, 2014

Earlier hospital release: Good news, bad news

I can't decide whether this story is good news or bad news - Ireland could free up 24,000 hospital beds by letting stroke patients out early:
The report found that 54% of stroke survivors, or more than 3,000 people each year, could benefit from a policy of ‘early supported discharge’.
This approach to rehabilitation allows patients to return to their own homes more quickly and intensive treatment is given in the home for a number of weeks. According to today’s report, this approach would require a substantial increase in the resourcing of community therapists (physiotherapists, occupational therapists, and speech and language therapists), community nurses and other community care above current levels in Ireland.
However, savings from the reduced cost of acute bed days could fund this increase in resourcing.
On one hand, hospitals are not healthy places. Lots of sick people and germs are present. You might or might not sleep well in a hospital. Family members are strained.

Yet, hospital is the place to be if you need it. Health professionals, equipment, treatment options are in the same place.

So I could see if this plan is executed well for people who would benefit more out of the hospital, AND services become available in the patient's own home: Good idea.

If executed not-so-well, releasing people who still need the services of the hospital just to save money in short terms (but would increase cost in long terms): Not a good idea.

I could see this sort of effort happen in the United States, too, with the ongoing debate about health care costs. So worthy of watching.


J.L. Murphey said...

I was released from acute care hospital after being stable for twenty-four hours. A total of six days which for me was good news because I went to a step down unit for intensive rehab. But because of insurance restraints I only received three weeks of rehab before I was sent home.

Not all of my deficits were identified leaving me lost and fending for myself at home. In-home rehab, twice a week,lasted a week before I was shuttled back and forth to outpatient rehab three times a week. Also I was left to judge what was more important with limited yearly visits. The thinking was adaptability versus recovery. Just enough to get by.

It was not enough time. I would have recovered faster in the step down unit.
BTW this is in the US.

Jeff Porter said...

Your story is a classic example of the bad news side of this. It's so dependent on the people who make these decisions and their motivation.