Leaving the Hospital Quicker and Sicker
Several decades ago, doctors controlled when we left the hospital, and people did not usually go home until they were well on their way to recovery. The suitable time to leave the hospital was the result of a discussion between the physician and the patient or a family member. There was no particular motivation to push people out unless there was a shortage of beds.
Today we live in a different reality. Hospitals, being short of cash, have a strong financial incentive to turn the beds over as fast as possible. This new financial incentive comes from the way private and public third-party payers changed the modes of payment. State regulators have adopted two different methods. First, there are the diagnosis-related groupings. This system pays a flat fee for each diagnosis regardless of the length of stay. Admitting two patients consecutively to one bed over ten days brings in twice the revenue as one patient occupying the same bed for the same ten days.
The other method of payment is straight itemized billing for room and board, products, and services on a cost plus basis. This form of revenue also provides a strong financial incentive to turn people over faster because usually about 80 percent of all billable hospital services occur within the first three days. The only difference is that with itemized billing, a low census provides motivation to let people stay a little longer if the beds aren't needed.