More problems with Medicare’s medical error P4P policy:
I am now more convinced than ever that policy is driven by money, politics and power, but I would have hoped someone would at least pay lip service to the science.
And in the NY Times, a letter with some real-world implications of the policy:
So, I admit Mrs. Jones, an elderly patient of mine, to the hospital because she has pneumonia. Because of the stress of the infection, she becomes delirious, which puts her at high risk of falling.In the interest of safety, I restrain and sedate her, which necessitates an indwelling urinary catheter.
One week later, despite meticulous nursing care, Mrs. Jones develops a urinary tract infection and a minor pressure sore on her back because of her debilitated, immobilized state.
My hospital administrator then suggests that I remove the restraints and the catheter and reduce the doses of her sedatives so that the conditions don’t get worse and our hospital doesn’t lose money.
Two days later, Mrs. Jones falls out of bed and breaks her hip.
How, exactly, has the new Medicare policy improved Mrs. Jones’s safety?
(via Medpundit)
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- Maybe we need Medicare to go bankrupt
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{ 6 comments }
It’s really just about appearances, like so many political endeavors.
You have to appear to be saving money, appear to be taking action, appear to know what’s going on.
Afterward, it’s a matter of juggling the numbers so it appears that you have accomplished something.
P4P is about as well thought-out as the invasion of Iraq.
I am Leviathan. I go where I will and do as I will. I am above reason, above justice, above consequences.
It’s all a push to remove any type of creative thought or problem-solving in favor of rigid algorithmic medicine. Sucks..
===
http://www.UroCanswer.com
I would agree that, in fact, Mrs. Jones is no safer.
But Mrs. Jones would have had problems anyway. Regardless of whether Medicare would or would not have paid for her infection, Mrs. Jones is one sick lady.
In the meantime, dozens or hundreds or thousands of patients ARE safer because the hospital was forced to take steps to be sure its patient safety practices were superior to what they were before Medicare was willing to pay for mistakes.
I’m sorry for Mrs. Jones. I’m pleased for those this new policy will save.
Trisha Torrey
EveryPatientsAdvocate.com/blog
“I’m sorry for Mrs. Jones. I’m pleased for those this new policy will save.”
This “policy” isn’t going to “save” anybody. Hospitals already have patient safety initiatives in place as a result of the bogus report from the IOM. And, as mentioned here ad nauseum, some of these “mistakes”, such as pressure ulcers, etc are not mistakes but complications of being sick. This is just a politically correct way for Medicare to save money, pure and simple.
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