Word: patiently
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Dates: during 1980-1989
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...admitted to San Francisco General Hospital. Mayor Dianne Feinstein charged that the transfer was "outrageous and inhumane," and Mervyn Silverman, the city's public health director, declared that the episode was "a dump of the worst kind" and accused Florida of "abandoning" an AIDS patient...
Last week those claims were bitterly denounced by Shands officials, who convincingly argued that they had acted in good faith, but the MacDonald case focuses attention on a growing medical problem: how to handle AIDS patients who do not need hospital care. Most victims who are discharged from hospitals, which have neither the facilities nor the money to handle them indefinitely, are forced to fall back on family and friends, plus the support of homosexual organizations. (About 70% of AIDS patients are gay or bisexual.) In Florida's Dade County, which encompasses Miami, only one of the 37 state...
...would pay for hospital care. "The incentive was perverse," explains Carolyne Davis, head of the Health Care Financing Administration, which runs Medicare. "The more hospitals spent, the more we paid." The new regulations place a ceiling on the amount a hospital receives for treating each ailment. Upon admission, Medicare patients will be assigned to one of 467 newly de fined "diagnosis-related groups," or DRGs, home on the nature of their jeopardizing Each DRG carries a specific rate of reimbursement. If the hospital treats the patient for less, it can keep the profit; if it charges more, it must absorb...
...ease the adjustment of hospitals to the new arrangement, which is called the prospective payment plan, the Government will phase it in over three years. In ;he first year, Medicare reimbursements for each patient will be based 75% on the hospital's usual cost for treating the ailment in question and 25% on the new federal rate. One year later, the formula will be 50/50. After three years, hospitals will be reimbursed entirely on the basis of the federal rate...
Nearly everyone recognizes the need for greater efficiency in U.S. hospitals. The challenge is to achieve this without jeopardizing patients. The American Medical Association fears that some hospitals will cut back on vital services or refuse to admit those who cannot be treated profitably. Part of the problem, notes Karen Davis, a health economist at Johns Hopkins, is that there is no allowance for the complexity of a case: "For example, you may have two patients with a broken hip, but one could have senile dementia and need a high level of nursing care." Under the new Medicare laws, hospitals...