Most medicare payments for pneumonia hospitalization

San Francisco >> << Aspiration pneumonia can be deadly and costly epidemic in older Americans, according to

William B. Baine, MD, who presented a poster at the 39th Conference of IL

on antimicrobial agents and chemotherapy. Pneumonitis due to inhalation

food and vomit, commonly known as aspiration pneumonia, was the second most common primary

diagnosis, conceding only that the broad designation of a comprehensive,

'pneumonia, the body without 'Among patients hospitalized Medicare >> << to any of 55 different diagnoses indicates infection or pneumonia

, said Dr Baine, who is senior medical advisor to the Centre >> << Results and Performance Studies Agency for Health Care Policy and Research

(AHCPR) in Rockville, Md. One possible explanation >> << to clear increase in aspiration pneumonia that hospitals increasingly

may strattera 40mg indicate aspiration pneumonia to get the maximum permissible compensation

from medical care, Dr. Baine continues. Even more worrying is the possibility that

[these diagnoses] may be detecting smoldering epidemic desire

, pneumonia in elderly patients. Several processes of disease diagnosis of aspiration pneumonia

included two different processes of the disease, Dr. Baine explained. One

version of the disease, spit out stomach acid goes down in the windpipe and

reaches the lungs. The result can be acid burn, providing lung tissue susceptible >> << complicate infection. According to another version often reflect other diseases that threaten

patient's ability to cough or swallow. For example, patients in yaks

throat muscles affected by the stroke may be at high risk of aspiration pneumonia >>. << Uncoordinated swallowing saliva misdirects, food, drink, or in the airways. If the cough reflex the patient is too weak, some of these materials can pass into the lungs

- with mouth and throat bacteria. Researchers examined the AHCPR

health care financing administration computer files Medicare hospital claims for

patients issued from 1991 to 1996 to determine the patient stay on

age of patients 65 years and over with primary diagnosis of aspiration pneumonia. From 1991 to 1996 the number of hospital discharges of Medicare patients

whose reason for admission, as reported, aspiration pneumonia increased by

76%, exceeding the 100 000 cases only in 1996, Dr. Baine he said. For >> << same interval, the number of seniors who are Medicare coverage increased

less than 7%. The annual increase in the number

hospitalizations for aspiration pneumonia per 100,000 person most visibly

in the very old. Average costs and Medicare hospital reimbursement were the lowest for

white women showed lower mortality in hospitals (23%). This subgroup

patients demonstrated the shortest average hospital stay (10. 4 days) and stay in the intensive care unit >> << (0. 8 days) and reached an average Medicare payment to hospital

to only $ 8246. Unlike black people at highest risk of death

(26%) had the longest average hospital stay (14. 2 days) and in intensive care

(1. 1 days) and were responsibility for the highest reimbursement Medicare hospital. Additional 22% of patients discharged to home alive or dead were self

within 90 days of hospitalization, mortality within 90 days were even

higher in patients directed to home care, intermediate care or skilled >> << elderly and disabled, or other entity. SECONDARY HIV diagnoses among Medicare patients with primary diagnosis

aspiration pneumonia, the three most common secondary diagnoses >> << are hypovolemia, congestive heart failure and urinary tract infection. Overall discharge diagnosis most strongly associated with primary diagnosis of aspiration pneumonia

- compared with a diagnosis of pneumococcal pneumonia - were dysphagia,

hastrostomiya status, and staphylococcal pneumonia. The question whether this increase in

in aspiration pneumonia occurs with real growth of such cases or

only apparent increase in pressure resulting from selection for aspiration pneumonia

diagnostic code. Most Medicare payments for pneumonia hospitalization

covers one of the two sets of diagnostic related groups (DRH): >> << simple pneumonia and pleurisy and respiratory infections and inflammation. As a last DRG includes pneumonia, which can be particularly serious, >> << hospital payment these are usually higher than for simple pneumonia. Reporting a patient with aspiration pneumonia and pneumonia,

body is not specified, the displacement DRG from lower to higher compensation

which is obviously in favor of the hospital. If, on the other hand, Medicare

account indicates a real increase in aspiration pneumonia, the second question

question: what is the basic process of this growth? To find out which of >> << needed further study, Dr. Baine noted. Further research

should focus on possible causal factors in his opinion, including >> << opportunity not previously link between some of these conditions or their

control and the risk of aspiration pneumonia . -Lawrence

Prescott