(Snippets from the frontline)
Medically wise, fiscally responsible
She passed away last week. I didn’t know her, but for 6 years I would say hello as I visited patients at a Board and Care.
They called her “Gramma” appearing to be in her 90s, and the caregiver said she was on hospice 4 years diagnosed with COPD.
Visits from the hospice agency were twice a week with supportive medical care, yet not allowed work-up when she developed an abdominal mass two years ago.
Here are the financial costs:
The lowest level of care for hospice pays $196 per day, whether the patient is seen or not. Multiplying this for one year equals $71,540. For Gramma, the total cost paid to the hospice agency by Medicare was $286,160, easily double the expense to live at the Board and Care those final 4 years.
Despite that, she still suffered at the end, and died as a result of the undiagnosed abdominal mass causing pain, renal failure and lower extremity swelling. Her COPD never played a role.
Utilizing hospice at end-of-life is important, but we must be medically wise and fiscally responsible to assure Grammas don’t suffer.
Gene Uzawa Dorio, M.D.
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