Some health systems and paramedic organizations are pushing to do more work in patients’ homes of the sort traditionally done in hospital emergency rooms. That most commonly involves older patients, many of whom make frequent visits to the ER and then are admitted as hospital inpatients, at great cost to payers.
And, The New York Times notes, “Geriatricians have warned for years about the ways in which hospitalization can accelerate older patients’ decline, even when physicians succeed in fixing the medical problem at hand” in an ER.
“Emergency rooms often serve as gateways to longer stays, and the time spent in bed leads quickly to deconditioning. Older people who walked in on their own often cannot walk out, and need rehab and physical therapy to try to regain their mobility.”
“They’re also vulnerable to hospital-acquired infections, including the rampant C. difficile, that can prove difficult to eradicate. Newly prescribed medications can interact badly with those they already take.”
“For all these reasons, plus the sky-high costs of emergency medicine and hospitalization, community paramedic practices are multiplying across the country,” to help keep patients in what is often the safest (and certainly most comfortable) place for them — their homes.
The Times notes that ”the concept may spread even faster if insurers, particularly Medicare and Medicaid, would cover at-home treatment by paramedics. Right now, emergency services are reimbursed only for ferrying people to hospitals.”
To read The New York Times story on this growing trend, please hit this link.