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Wednesday, April 22, 2015

Iatrogenic...PO Day 307

Iatrogenic:  of or relating to illness caused by medical examination or treatment.

In an effort to reduce hospital acquired infections and complications of treatment, CMS (centers for Medicare and Medicaid) made the decision that they would not pay for HACs ( hospital acquired conditions) when fourteen different situations occurred. This had the added benefit of reducing the cost of care since previously CMS had covered such events. Now they are implementing the next phase in which hospitals will be scored for adverse events resulting in HACs and poorly performing hospitals will not only not be paid, they will be penalized financially. 

In a related analysis of patients, statistics show that you are much more likely to acquire an HAC if you are admitted to the hospital on a weekend rather than.a week day. Weekend admission is linked to worse outcomes for several life threatening conditions such as myocardial infarction, pulmonary embolism, and intracerebral hemorrhage.

Why would that be? One could argue that weekend admission patients tend to be more seriously sick.  But it could also be that staffing problems leave hospitals short handed. Perhaps doctors
are less available on weekends? Do lab reports get processed as quickly on weekends?  I do know that when my collapsed lung was discovered on a Friday afternoon a thoracic surgeon was not available and the ER doctor had to treat me. It was a less than ideal situation.

So, if you develop an HAC know that your hospital isn't going to be paid for taking care of you. Will that have any effect on your treatment? It certainly seems reasonable to believe cost will be a consideration.  And try to avoid dealing with the problem on the weekend if possible. But we all know that things are always worse at night and on the weekend. 

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