Hospitals hang on to insured patients when transfer might be better

It’s been almost two months since I posted anything! The main reason for that is that I now have a new job, a full-time job as the business manager of a museum. It’s a nice transition, but the accounting needs of this place are large, so I don’t get much time to ponder neonatology the way I used to.

On the way home from work a couple of days ago, I heard this story on National Public Radio, about the trend of what small private hospitals do with their patients depending on whether they have insurance. There’s a tendency called patient dumping, where private hospitals try to transfer uninsured patients to public hospital. This story was about private hospitals keeping trauma patients if they have insurance even though they would benefit from being transferred to a trauma center.

Towards the end of the story, the correspondent cites another study about premature babies and higher mortality rates in smaller hospitals. The cited study, from the New England Journal of Medicine, said “The risk of death was significantly higher in level 3B and 3C NICUs that treated 50 or fewer very-low-birth-weight infants per year than in units with larger volumes.” In one of the appendix tables, the study’s authors project that there could be a 21 percent reduction in mortality if 90 percent of very-low-birth-weight infants were born in facilities that served more than 100 VLBW infants per year.

Our Gabriel was born at a hospital with one of the largest NICUs in the Northwest, so we never got in to the question of whether he was in the right place, but this is something worth writing more about.


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