The District of Columbia and federal governments wasted $1.2 million last year paying for hospital care for patients who belonged in nursing homes, or their own homes, a report released yesterday said.
Figures compiled by the National Capital Medical Foundation showed that the Medicare and Medicaid programs paid for 40,302 days of medically unnecessary hospitalization for 1,116 patients in D.C. hospitals.
The situation is caused by a lack of beds in nursing homes and other extended care facilities, according to the foundation, a federally funded health care review group.
"The problem is there's no place to send these patients if you discharge them," said Dr. Robert L. Hackney, Jr., the foundation's president-elect. "The patients either have to go back to a rooming house, where some of them live, or into the streets."
It costs $30 to $50 a day to keep a patient in a nursing home, or at home, and $200 to $300 a day to keep the same patient in a hospital.
One of the major concerns, said Hackney, is that many hospitals do not plan ahead for patient discharges.
"These cases have to be looked at early on in the game," he said, "rather than a few days before discharge. If the hospital waits too long, a nursing home bed may not be available for months and months . . . But even when they do plan, the number of (nursing home) beds is inadequate."
Although the number of such patients rose 35 percent last year, the number of days those patients were hospitalized increased by only one percent over the previous year, the study said.
This suggests that hospitals have developed better techniques for placing patients after their hospital stays, the report said.
The report gave no figures for individual hospitals in the District of Columbia.
According to the report, the hospital stays of patients who belonged in nursing homes, or other facilities, averaged 59.2 days, while the stays of other patients averaged 9.9 days.
Although virtually all the "inappropriate" patients were waiting for a slot in a nursing home, the report points out, only about 17 percent of patients eventually went to nursing homes. About 61 percent went home, 10 percent died and one percent were sent to other hospitals. The report does not account for the remaining patients.