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Show ByRT0M BUSSELBERG Kelex Journal Editor 5EFkUL " that's an initials don't baffle -t lrl generic" drugs, home spice care will. idrtnK0t' that terminology dal peworIdf medicine, W tK senior citizens, "ed ; ' in! maze must be pene-tee pene-tee ti! uast understood to l"e best possible health SEvERai 1 nsw,r hundred senior 1 s and th exPsed to those J11 i:( nd o.h'r reJation to Medi" 0 fromch1 " health-related insu lce of supplemental HowtoRead Hospital Bills and Medicare Statements." State-ments." That wide array of topics was explored at the 1985 8th annual Mini-Conference on Aging held at the Golden Years Senior Citizens Center in Bountiful, Thursday. AIMED AT providing "cost containment" con-tainment" while still striving for top-quality health care, Medicare revisions now make payments based on the "average" cost for a procedure or diagnosis. A hypothetical case of gallbaldder surgery has a woman hospitalized for five vs. ten days, a filmstrip "Knowing Your Rights," says. Produced by the American Assoc. of Retired Persons, it notes hospitals are paid a set cost for an operation. If they can provide it at less than the $3,000, say, the hospital hos-pital pockets the savings. If their costs exceeds that, however, the hospital must pick up the tab-not pass it on to the patients. IT'S MEANT a reduction in the average number of days a patient is hospitalized, fewer tests are often performed and more reliance placed on other sources for health care after leaving the hospital. Sue Charles, of Humana Hospital Hospit-al Davis North in Layton, explained ex-plained her role as a "discharge planner." She and similar staffers at other hospitals meet with the patient, pa-tient, family and physician to determine de-termine what services will be needed upon discharge. THAT'S confined usually to those with strokes, terminally ill, over age 75 living alone or who've undergone extensive surgery. "We try to choose those who need extra help," she explained, noting the entire hospital staff is involved, where possible, in such planning. Sometimes, patients are released re-leased from the hsopital when medical personnel feel they're ready but the patient may not be comfortable, Dr. Gary Lower, a Bountiful surgeon, said. Emphasizing Empha-sizing there are "no hard and fast answers," he said the potential for less costly, but adequate service outside the hospital must be considered. consi-dered. IF A patient can't walk that isn't reason alone to remain hospitalized, hospital-ized, Dr. Lower said. Eating, pain killer, administration and exercise may be done elsewhere. Physicians used to keep women a week-10 days after giving birth, for example, but now medical authorities au-thorities agree it's best to get a patient pa-tient back home as soon as is safe, he added. PHYSICIANS are paid at 1979- '82 rates by Medicare meaning about ab-out a 50-60 percent return for office calls, for instance, Dr. Lower indicated. indi-cated. About one-third of doctors accept government payment without with-out question while the others want to determine whether they'll participate parti-cipate case by case, he explained. President of the Peer Review Organization for Utah, Dr. Lower explained that body's role. Newly set up, it's geared to review hospital hospit-al treatment of Medicare patients although not all cases are studied. Patients have a right to ask for such scrutiny and should educate themselves them-selves to rules and regulations and not be afraid to ask questions, he emphasized. HMO'S, one of those abbreviations, abbrevia-tions, were explained by David Call, executive director of Maxi-care Maxi-care Utah, one such group. Similar to an insurance company, patients may choose to affiliate with a group, receiving treatment from a "primary care physician" although other care can be provided pro-vided through such a facility as well. "Generally an HMO can give a little extra coverage at reduced cost," he explained. Currently, no Utah HMO's participate par-ticipate with Medicare but that should change by spring, he said. "IT'S A cost vs. care" balance that must be maintained, Lakeview Hospital Administrator Linn Car-riger Car-riger said, with attempts stressed at providing care in a "human, rational ration-al way." Other topics covered included "Nursing Homes: Who Pays for Them?" and "Community Services: Ser-vices: Where Can I Get Help When I Come Home from the Hospital." |