Friday, March 2, 2018

Hospital admission vs home care

In school, we loved to fall sick. That is because, if you were ill, you got an exemption from many activities like attending parades, physical training, compulsory study sessions, etc. Besides that, you were looked after like a king in the hospital.

Post student days, when we are on our own, it's a different ball game. Forget getting admitted, a visit to a hospital for consultation itself comes a big cost, unlike in the school days. Many doctors would recommend umpteen tests as a part of the diagnosis. I won't blame the doctors. Because unlike earlier days, today we have very sophisticated instruments and tests. Why shouldn't a doctor use them, if that can help him understand the symptoms better.

If one's condition necessitates admission, then that can prove to be quite expensive. Of course, if there is medical insurance, that can partly take the load; but then it's still quite a hassle.

I recently read an article in The New York Times Are Hospitals Becoming Obsolete?

It had pointers to some interesting trends. Apparently, the age-old practice was to get treated at home. Only people who were extremely sick went to a hospital. And, not many came back alive.

Gradually, a spate of inventions and discoveries led to an increase in the number of people who visited hospital or got admitted.

But in the US, that trend has now bucked, so much so that the number of hospitals itself is on the decline. 

The maximum number of hospitalizations in the United States was in the year 1981. The article says:
"That year, there were over 39 million hospitalizations — 171 admissions per 1,000 Americans. Thirty-five years later, the population has increased by 40 percent, but hospitalizations have decreased by more than 10 percent. There is now a lower rate of hospitalizations than in 1946. As a result, the number of hospitals has declined to 5,534 this year from 6,933 in 1981."
The clock has come a full circle. Chances of survival in hospitals are coming down, because of various factors like contracting infections. There were 1.7 million cases of hospital-acquired infections that caused nearly 100,000 deaths, the article says.

The new trend is for home care, where the environment is more conducive for a patient's recovery. There is now a better market for home nurses, community health care workers and staff at outpatient centers.

I don't think hospitals will ever become less relevant or they will vanish all together. If one's health condition is too bad, one has to visit a hospital or get admitted. Or else, the condition will deteriorate. I know so many cases, when hospitalization was required to treat the illness. Often hospitalization has given them a new life altogether.

That doesn't mean we run to a doctor for very discomfort one feels. Our body does heal naturally. So, give it some time, before approaching a doctor.

Where home care will work are in conditions that don't require major inventions, like surgery, and constant monitoring. It's quite possible that post illness recovery could be quicker at home than in hospitals.

What are your thoughts?


  1. Pradeep, what NYT says won't happen in India. Hospital industry is a rich parallel economy. Doctors will die in penury if such a thing happens!

    1. Mohan, that's too harsh a comment on doctors. :-)

  2. Home care is much better. In USA, health insurance companies dictate everything regarding hospital stay. Hospitals have to get prior authorization for anything and everything. Many hospitals are fed up with the insurance companies. Some hospitals have started to sell their own insurance plans.

    1. Indeed, SG. Health insurance is a big factor in the US. We can all see that.

  3. This has nothing to do with this blog post. Since I do not know your email address, I am writing here. There are already 3 or 4 movies about the Entebbe rescue by Israeli commandos. Another movie is being released this Friday titled "7 Days In Entebbe". Thought you might be interested. I certainly am going to see this movie.

    1. Thank you very much, SG, for letting me know this.
      It's releasing here too tomorrow. I must watch it.