Often our patients are admitted to a number of different local hospitals in the U.S. and predictably the "Insurance company owned hospital provider of medical care" = "Hospitalist" will provide care that is less than accurate. We spend a growing amount of time after the patient is discharged in coordination of care that should have been completed during hospital stay - but to match DRG and value based payements the diagnosis and treatment is often ignored. I am wondering if any other physicians have found solutions to working with the hospital groups to improve the quality of care by bridging the gap between the need of profit v. the need of patient.
The issue may be important in developed countries like USA, it is surprising that even in that scenario the quality is compromised. it is a lesson to developing countries where the health insurance is growing very fast. But it requires some efforts from regulators so that access to poor is not compromised. In developing Countries while the quality of health care is acceptable upto some extent in private set up but it requires improvement in public health care set up.
In the era of Universal Health Care it is challenge that quality of health care is not compromised.
As far as concerned to India then I would like to say that a lot more is required in this direction.
in pakistan hospitals are business centers. doctors are cruel people, 99% did not pay taxes according to their income. one of the most corrupt profession in pakistan
Since the advent of managed care during Nixon's adminstration, more and more "middle men" (go-betweens) or intermediaries are in the picture taking away part of the money in the system recurring "adminstrative costs." These intermediaries are also inserting themselves in the prescription drug industry such as CVS, Express Scripts, etc. Thus the insurance companies now largely dictate what treatment the patient should receive. Bernie Sanders' Medicare for All may hold the answer provided all the intermediary bureaucrats are totally eliminated, the doctor is the sole medical decision maker and the billing of Medicare is managed by a small local clerical group attached to the hospital or clinic.
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