The University of Maryland hospital CEO has apologized after a citizen videotaped a young woman who had been dumped on to the street in a hospital gown and socks in cold weather. Critics called the incident “patient dumping” which has happened in Los Angeles and other cities. It is stunning that the CEO of the hospital was surprised and shocked by this incident. Obviously, any management policies to provide comprehensive discharge planning were not being implemented aggressively at the hospital. The message obviously was not getting to front line discharge staff.
Sending people out into the street or in a taxi in the middle of night is something that has happened before including cases we are aware of the past few years in Albany. All of that is hopefully changing as hospital systems in New York State are breaking ground trying to work with human services agencies in their communities to deal with the social circumstances of patients. Hospitals also are being penalized for unnecessary re-admissions which is pushing them to work with community agencies on care transitions.
New York is trying through its DSRIP Medicaid program to encourage care transitions and care coordination to make sure that patients are followed home with a care plan and support services with medical homes and other methods including using patient navigators. Hospitals and health providers are seeing payers move toward “value based care” which will be changing fee for service payments to those which are outcome based, assessing whether the care provided made a difference in a patient’s health status. This value based payment system is going to become increasingly the basis for payment in Medicare as well. Critics of the health care system say the “outcomes” are more important that “outputs.” meaning improvements in health status for patients and the population vs. the number of visits.
Here’s a link to the story in the Maryland hospital