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Costs of Care

November 08, 1987

As a hospital social worker, I found your article, "Crisis Point in Caring for the Elderly?" (Nov. 1) especially relevant in targeting a major problem in health care, lack of adequate funding for long-term care.

What was not mentioned was the exorbitant cost of keeping patients waiting in acute care hospitals for nursing home placement. Medi-Cal doubtless pays 2 1/2 times more to an acute hospital for those patients on "administrative days."

My colleagues in other hospitals and I have noted a "logjam" of patients awaiting placement since the closure of the three facilities you mentioned. I'm sure facilities are very careful to choose only those lighter-care patients that they can adequately care for. I even have patients who could pay for care privately who are difficult to place because of their "acuity" of care (i.e., intensity of nursing needs).

It can't help but be cost-effective to increase reimbursement to skilled nursing facilities in order to reduce costly payment and unnecessary use of an acute hospital bed.

PAT GREEN

San Diego

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