They assumed she was demented: Health care at home

Dr. Jack Resnick's story:

I had one 83-year-old patient whose arthritis kept her from moving around, but she loved to talk about her career as a rocket scientist. One day, a well-intentioned neighbor dropped by and called 911 after finding her feverish and dehydrated from diarrhea. My patient had never been treated before at that hospital, and as a Russian immigrant, had no family here for the hospital to contact. She became disoriented; the hospital assumed she was demented and transferred her to a nursing home. It took me two months to track her down and many more to get her home, where, among well-kown attendants and friends, she became lucid again. If she had lived out her days in an institution, she would have cost Medicare a great deal of money, and her life would have been shorter and far less happy.

Patients who are treated at home by a doctor and nursing staff who know them intimately and can be available 24/7 are happier and healthier. This kind of care decreases infections, mistakes and delirium. And it is far more efficient. According to a 2002 study, for the patients treated by the Veterans Affairs' Home Based Primary Care Program, the number of days spent in hospitals and nursing homes was cut by 62% and 88, respectively, and total health care costs dropped 24%.

Thanks to Dr. Resnick, whose article in today's New York Times is excerpted here.