Friday, November 09, 2012

New level of care in the ER


I had to go to the Emergency Room a couple of weeks ago—so dizzy I could not stand. I was not put in a gown and bed and denied food and water as in past trips.

Instead, I was put in a recliner chair in a small room with two other patients and a nurse coming and going. I got tests from there—fully clothed. Blood, CT, etc. We ate trail mix and no one scolded us.

I took this to mean that ERs were getting used to being people’s doctor. They had simplified it. But it might mean they are going for the new “observation” approach.

Laura Landro wrote about this in the WSJ, Nov 6, 2012. Instead of admitting people to the hospital, they are sort of put in a limbo area and watched.

This can cost patients more on Medicare—hosp admittance may be largely covered, but the copay for this may be higher.

A little more than a third of ERs have these units now.

Usually the stay is under 15 hours, but 7.5% of Medicare patients are kept 48 hours or more. Also—Medicare only pays for a nursing home if the patient is in the hospital for three days—without being admitted, how does this work?

Medicare will rule on this on 2014—they recommend you ask whether you are admitted.

I got OK attention from a doctor, a nurse, and a Physician Assistant in my little recliner chair. I know I will owe at least $400 for my part of the treatment and the ambulance.

What was wrong with me? Don’t know. I am somewhat better and take sea sickness pills now if I feel icky.

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