How Does Hospitalisation Work Out In Your Country?

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dharmacorps
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Re: How Does Hospitalisation Work Out In Your Country?

Post by dharmacorps »

Justsit wrote:
dharmacorps wrote:

When I was doing discharge planning, we had a 90 year old patient who had cardiac issues. She and her daughter had decided against having surgery, until the cardiac surgeon came to the floor and heard they had declined. The surgeon went in the patient's room, spoke with them, and came out twenty minutes later with a signed consent form for a 6 vessel coronary artery bypass. The patient had the surgery, and survived, but never regained consciousness and never came off the ventilator, until she died septic still in ICU 6 weeks later. Total cost exceeded $500,000. These types of decisions are what put costs through the roof.
There are surgeons who will risk (both risk of losing a patient and risk being sued) these sorts of procedures, but this kind of thing is a reminder that regardless of what doctors advise, it is the patient's choice at the end of the day. Both doctors and families can push for overzealous treatments. That's how you get something like 80% of all your healthcare expenses as a person come in the year before your death. This also has some tie-ins with the paradigm of western medicine in general-- war against disease rather than an idea of living with it.

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No_Mind
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Re: How Does Hospitalisation Work Out In Your Country?

Post by No_Mind »

Lux wrote: The waiting hasn't been too bad. I haven't really had any major issues at all since that major attack, so I am basically back to normal it seems.
:namaste:
Lux, I wish you have a very successful operation and a pain free and quick recovery,

:namaste:
"The struggle itself toward the heights is enough to fill a man's heart. One must imagine Sisyphus happy.”― Albert Camus

Lux
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Re: How Does Hospitalisation Work Out In Your Country?

Post by Lux »

No_Mind wrote:
Lux wrote: The waiting hasn't been too bad. I haven't really had any major issues at all since that major attack, so I am basically back to normal it seems.
:namaste:
Lux, I wish you have a very successful operation and a pain free and quick recovery,

:namaste:
Thank you :)

For now I am still pain free. I'm honestly at the point where I am considering calling my surgeon tomorrow and seeing if I can just wait and observe on a low fat diet and see if the problems persist in the future. They've seemed to have all but stopped after that major attack. I may have passed a stone and not known.

:namaste:

Lux
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Re: How Does Hospitalisation Work Out In Your Country?

Post by Lux »

I have my operation date. 24th March.

Should be in and out of hospital in 6~ hours.

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Mohan Gnanathilake
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Re: How Does Hospitalisation Work Out In Your Country?

Post by Mohan Gnanathilake »

Theravada Buddhists are most likely to accept medical advice when it is clearly explained and the options fully explored. Doctors and nurses are generally held in high esteem in Theravada Buddhist cultures because helping others and relieving suffering are important in Theravada Buddhist training.
All thoughts begin in the mind, mind is supreme and mind-made are they. If one speaks or acts with impure mind pain follows him like the wheel the hoof of the ox.
(Dhammapada 1, Yamaka Vagga – The Twin Verses)

All thoughts begin in the mind, mind is supreme and mind –made are they. If one speaks or acts with pure mind happiness follows him like one’s shadow that never leaves.
(Dhammapada 2, Yamaka Vagga – The Twin Verses)

alfa
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Re: How Does Hospitalisation Work Out In Your Country?

Post by alfa »

Lux wrote:
Mon Mar 06, 2017 11:38 am
I have my operation date. 24th March.

Should be in and out of hospital in 6~ hours.
So basically the whole thing is free? Cool.

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confusedlayman
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Re: How Does Hospitalisation Work Out In Your Country?

Post by confusedlayman »

No_Mind wrote:
Fri Mar 03, 2017 5:52 am
This is how hospital visit for pre-planned surgery happens here. I would really like to know if it is same in U.S, U.K, Australia and other countries.

Characters -- James and his wife Susan. Susan has terrible upper abdomen ache at 11 PM on Feb 15.

Feb 16 7 AM -- she is first treated by general practitioner or GP (called family physician) at her home and given Tramadol injection.

Feb 16 11 AM -- James decides to take his wife to nearest big hospital OPD (outpatient department). At 2 PM she is seen by a gastroenterologist who suspects gallstone and prescribes an ultrasound and MRI of abdomen. Ultrasound is done but MRI not done that day.

Feb 17 9 AM -- Susan undergoes MRI and waits for the gastroenterologist whose clinic hours are from 12 PM. At 2 PM gastroenterlogist confirms gallstone and suggests to her name of a reputed hepato-billiary surgeon at same hospital. But since the surgeon is busy he cannot meet the patient that day.

at this point usually Susan should seek second opinion from another gastroenterologist.

Feb 18 2 PM -- Susan meets the HB surgeon who prescribes pre-operation screening tests (fasting sugar, post prandial sugar, complete blood count, tests for HIV and Hepatitis C, liver function test, creatinine, ECG). Since Susan has already had food, no blood tests can be done on that day.

at this point usually Susan should seek second opinion from another HB surgeon

at this point James should check if other hospitals are better / cheaper etc. Looking for a new hospital is skipped by most.

Feb 19 Sunday -- all labs closed

Feb 20 8 AM -- Susan has blood drawn for fasting sugar and liver function, complete blood count, creatinine, HIV and Hep C test. She has coffee and 2 slices of cake at 9 AM. At 10 AM she has ECG done. At 12 PM she has lunch. At 2 PM she is tested for post prandial sugar.

Feb 21 11 AM -- James puts together all documents (prescriptions and reports) and applies to medical insurer for permission to proceed with operation.

Feb 23 -- insurer gives permission to proceed. till now Susan has been an outpatient

Susan cannot have operation on 25th because next day is a Sunday and surgeon will not be available in case of any emergency. Only resident medical officers are available on Sunday.

Feb 27 10 AM -- Susan is admitted to hospital in morning. At 1 PM she has gallbladder operation. At 2:30 PM she is shifted to to post operation observation ward and at 4 PM returned to her hospital bed/cabin (in case it went south she would have ended up in some kind of intensive care ward).

Feb 28 -- she is kept under observation.

Mar 1 11 AM -- HB surgeon and resident medical officer on duty signs discharge certificate. She is released at 5 PM after insurer clears her dues with hospital. Insurer pays for hospital stay, surgery charges between Feb 27 and Mar 1.

All expenses prior to Feb 27 (3 x doctor fees, MRI, USG, pre-op screening costs) has to be claimed separately by James from medical insurer.

On the days marked red, James has to take leave from work (at least 6 days and probably 7; will be 8 - 9 days if second opinion is sought). The days are not consecutive that James can take one week long leave but take leave as needed.

Is it the same in other countries? Such as is it that in U.K James can just go and deposit Susan at hospital on Feb 16 at 8 AM and go to work and visit her once or twice daily for duration of her stay? It cannot happen here because insurer would not agree to it. It could happen if someone paid it out of own pocket.

I would be glad if anyone could throw some light on this.

Note i -- I am not speaking of immediate hospitalisation in case of heart attack but a pre-planned surgery such as gallstone where the patient is too weak to be left alone in a hospital as out patient and too strong to be admitted as an in patient.

Note ii -- all steps marked in italics should be done but James will be sacked if he takes any more leave.

Note iii -- Feb 21 and 23, insurer steps could be eliminated if one goes for an all cash procedure.

I am asking because in my extended family I am the doctor and hospital expert guy. Due to a strange coincidence I had to take care of three surgeries in three different hospitals (all pre-planned) in last 10 months and I am quite curious about other countries and how it happens there.

Hospital stay and hospital visits are the most traumatic things that can happen (apart from getting tangled in a legal case or being sued) to one.

Is it more streamlined in U.S or U.K or Europe? Here by the time the patient Susan is ready for release, James is ready to be admitted for exhaustion.

:namaste:
in India and USA u have to pay by own pocket.. in india govt hospitals free 90% but conditions are worse... in private hospitals they charge u a lot and also put other charges and unwanted test to maximize profit. in Uk its completly free but u might need to wait in line. In most countries its not free and sometimes insurance wont cover maximum of surgery that are extremely costly..
Master said dont neglect concentration ... practice jhana "O dhamma wheel users! "

santa100
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Re: How Does Hospitalisation Work Out In Your Country?

Post by santa100 »

No_Mind wrote:Is it more streamlined in U.S or U.K or Europe?
The States provides the best service, in the most timely manner,... but with the most expensive medical bill in the world. So it all depends, your're in luck if you have have a full-time job with a company that gives good medical/dental/vision insurance coverage; you're not if your company is cheap, or unemployed, or a freelance contractor/consultant who has to pay for health insurance himself.

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No_Mind
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Re: How Does Hospitalisation Work Out In Your Country?

Post by No_Mind »

santa100 wrote:
Thu Apr 02, 2020 1:51 pm
No_Mind wrote:Is it more streamlined in U.S or U.K or Europe?
The States provides the best service, in the most timely manner,... but with the most expensive medical bill in the world. So it all depends, your're in luck if you have have a full-time job with a company that gives good medical/dental/vision insurance coverage; you're not if your company is cheap, or unemployed, or a freelance contractor/consultant who has to pay for health insurance himself.
Hi Santa100,

Quite old thread. I have since found that we have the PPO model here (as in States).

Expensive, fast and efficient.

:namaste:
"The struggle itself toward the heights is enough to fill a man's heart. One must imagine Sisyphus happy.”― Albert Camus

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