Why doctors discharge patients too soon or too late?

There was this patient who went through a surgery, after which, her sister-in-law left her at the hospital right away that she has no one around and she could not eat for several days. After the other patients were discharged, she wasn’t discharged yet until she felt prepared to go home both physically and mentally.  She knew that during the time her step dad went through an operation for a triple heart bypass, he was able to recover 5 days after the surgery, but the hospital didn’t discharge him right away.

Somehow, she has similar stories with other patients. The patients are usually left thinking why they were discharged from the hospital right away or why they were discharged quite late. They also thought of some things that the doctors use to determine if the patient is ready to go home or not. It might be troublesome to think and that depends on a lot of clinical factors, though according to Dr. Jha of Harvard.  She even added that there are times when the doctors over count the numbers of support available at home and so they discharge a patient right away and there are times when they underestimate and so they discharge quite late.

The responsibility is transferred from Medicare to the hospital

The economic incentives may also be a culprit why the patients may tend to stay in the hospital quite long. Any current changes on how the hospitals are paid seem to affect the patients who are admitted and how often they are readmitted. But it is clear enough that the hospital stay is quite long, however, in 1980s the average patient stays in the hospital for 7 days. At present, the patients used to stay in the hospital for 4 and ½ days only. It is quite different now because the patients who are brought to the hospital are younger and healthier when compared to the patients in the past, so they tend to be discharged earlier.

There is one of the primary reasons why there is a sudden change from 1980s. Medicare has stopped paying the hospitals for whatever claim it may be and then phased in a payment method that will pay them a programmed rate linked to every patient’s ailment. This is called the prospective payment method wherein they have transferred all the financial risks of every patient from Medicare to the hospital, thus persuading the entity to save money. One way to save money is to allow the patient to go out of the hospital as soon as they are well.  The possible payment method pays the hospital the same amount if the Medicare patient stays and uses their facilities for 4-5 days, but for an additional day, it will add costs that will hit the hospital badly. This goes to show that the hospitals handle their finances very well and they do this by asking the doctors to discharge the patients right away. A doctor who practices in Boston once said that the hospital admin. Told him do not allow the patients to stay in the hospital for too long