DISQUS

kris · 10 months ago

i worked in a nursing home before returning to the hospital and most of hospital transfers were driven by the families...if the resident became ill. the medical director ordered treatment but some families would just insist they be sent to the hospital. Now that I'm back in the hospital I see more and more bogus admits of nursing home patients....uti and mental status changes will both clear up most of the time with a little po antibiotic and some extra glasses of water.the chf with crf were treated symptomatically without overkill. most pneumonias again po antibiotics. simple and unsophisitciated yes but we had a very low mortality rate and we kept them out of the hospital. we always asked people if they wanted their family menmber to go to the hospital and the ususal response was no keep them with the people they know unless it was a legal gaurdian,, then they would get whisked off for a hangnail.

Anonymous · 10 months ago

With all due respect Happy, your title is very misleading. The intervention assessed in this article was about off-site phone-based care coordinators. It was not an evaluation of the PCMH as currently envisioned.

For a really good explanation of the difference between off-site care coordinators and the PCMH, please read John Ayanian's commentary in the same JAMA issue. I think you'll find it enlightening.

The Happy Hospitalist · 10 months ago

Point taken.

Anonymous · 10 months ago

How about giving physicians $3000 for every patient that they put on Hospice? That would incentivise docs a ton to put folks on Hospice and save the system some money. What a great idea - pay people to not deleiver health care. Just like the Dept of Agriculture.