04 February 2011

Is This Another Form Of Medical Rationing?

Researchers did not do this study justice. They had the opportunity, but apparently chose to leave a lot out to spur speculation like I did at first. When I first read this, I was very angry. With the care in the local emergency unit being so variable depending on the doctor on duty and level of expertise and experience, I thought that trauma centers would be much better – wrong.

About one quarter of 87,754 trauma patients or about 22,000 being elderly, this is a sorry statement that only nine of 131 trauma centers in the US were highly rated for care of the elderly. Then to say “in the study we showed that although some centers demonstrate high performance overall, these same centers might not be providing the same high-quality care to the elderly," really lays the fault on the trauma centers and their administration and staff.

This statement "We've shown that elderly patients have different needs from young patients. Centers need to focus on the needs of the elderly specifically in order to improve their quality of care," defines problems in general for trauma centers. When trauma centers are not prepared to deal with the elderly who may have heart disease, lung disease, or diabetes, this shows how ill prepared the staff is or that the training is totally inadequate for the situations trauma doctors face in the trauma center.

Why did I use the title I did? Because this is a situation where there are many places to find fault. First, I am confident that the level of Medicare reimbursement is very low, which means that the trauma doctors are not wanting to spend much time on the elderly. This also means that the administration of the trauma centers are also discouraging doctors from spending much time on the elderly.

To me this means medical care rationing by Medicare. Yes, I am in this group that Medicare will be limiting care for and I am still angry. I can also guess that the “baby boom” generation following me will not be happy with this and will be even more vocal. This is why I place most of the fault and blame on Medicare for encouraging this rationing of medical care.

Now the other areas that can be creating problems and deserve a portion of the fault. It seems that the training received for trauma doctors is lacking for the elderly and they don't have geriatric training for dealing with the elderly. Their training may also not involve dealing with the elderly that have chronic diseases. So I would think that additional training should be necessary.

With the new Affordable Care Act (now unconstitutional), these concerns will continue to mount for people age 65 and older. You know that the governments at the local through federal will be receiving complaints and if care continues to be rationed, voters will insist on change.

Read about the study here.

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