Those in nations with universal healthcare

[eilen]

How do the hospitals deal with patients who want to be residents? For example, we had a patient who just was refusing to be discharged from the hospital even though they are healthy or stable enough to go home. Our hospitals are set up for acute care, not chronic care-- we treat chronic conditions but only when there are exacerbations, not "for good" as a residential spa. Sometimes we have patients that can't go home but they are not appropriate to remain in an acute care setting but they refuse the nursing facilities that are offered. Even though they are aware that the longer they stay the higher risk of infection of superbugs. One lady we took care of insisted on a 5 day stay to receive chemotherapy that is normally an outpatient procedure. If we insist she go home, she just turns up back at the ED.

[muriel_volestrangler]

1. Those who would be better in long-term residential facilities can be a problem

The phrase 'bed blockers' is often used in the UK:

Bed blocking in NHS hospitals got worse last year and was responsible for an estimated million lost hospital days, a survey revealed yesterday.

Lost bed days rose to nearly one million last year with the cost to the NHS spiralling to £200 million.
...
The Department of Health's move to introduce fines against local authorities which are unable to place hospital patients in the community or care homes has done little to halt the problem.

Latest figures revealed a catalogue of cases where patients have remained in beds for years even though they no longer need hospital-level care.

http://www.telegraph.co.uk/news/uknews/1553520/A-million-days-lost-to-bed-blockers.html

I think those who can go home are just told to go; but of course in each individual case, there's a lot to be taken into consideration - how much care from others the patient needs, how much others living at home can give, and so on. It can be misleading to pronounce on what should happen without knowing details.

[Cassandra]

2. I've been wondering if they have a problem with fraud.

Particularly billing for fictitious patients or procedures. How do they monitor that, or do their doctors just not have fraudulent impulses because a different personality type goes into medicine?