Cases & the Price Tag of Health Care

1. W E J U S T W A N T T O M A K E T H E W O R L D
D A N C E , F O R G E T A B O U T T H E P R I C E
T A G
T R I A G I N G A N D H O N O R I N G O U R PAT I E N T S ’
F I N A N C I A L R E S O U R C E S I N T H E M O D E R N
M E D I C A L E R A
R . B E N Z A R , 1 1 . 1 . 2 0 1 8

2. Cirrhosis (2/2 burnt-out fatty liver),
mild ascites, portal HTN, grade I
esoph varices 2017, para w/i last mo)
B/L hydro, B/L ureteral
stents 7/2018, chronic
indwelling Foley
Cervical CA  hyst 1994, EBR
 BLEEDING; radiation
vaginitis/strictures/
reconstruction; radiation
cystitis, proctitis; getting HBO2
TX
Fibromyalgia, chronic
pain, previously on
hydrocodone; multiple
falls in the past; daughter
requesting more aggressive
pain control
W E ’ L L S T A R T W I T H M R S . S M I T H .

3. 8 / 2 9 – Y O U M E E T M R S . S M I T H ; S H E I S
W O R R I E D A B O U T A B D O M I N A L P A I N
1 0 / 3 - H B O 2 T X
1 0 / 3 P M – E D V I S I T, C C A B D P A I N ; D I A G P A R A
1 0 / 4 – T H E R A P E U T I C P A R A
1 0 / 6 – D / C F R O M H O S P I T A L
1 0 / 8 – H E P A T O L O G Y C O N S U LT A T I O N
1 0 / 1 1 – L I V E R B I O P S Y
1 0 / 1 9 – P A T I E N T C A L L S U R O O F F I C E
R E G A R D I N G P A I N ( B U T P A I N R E S O L V E S )
1 0 / 2 4 – C O M E S T O S E E Y O U I N C L I N I C
R E G A R D I N G P A I N ; Y O U C E R N E R M E S S A G E
U R O L O G Y ; S T A R T A L F U Z O S I N
1 0 / 2 7 – P A T I E N T R E - A D M I T T E D F O R
P A I N / R E C U R R E N T H Y D R O N E P H R O S I S

4. A N D N O W M R . S M I T H .
Lymphedema &
DM2, c/b
neuropathy,
DM2 foot
wounds/
ulcers/HX of
osteo

5. 1 0 / 1 5 – P O D I A T R Y + I D / W O U N D A P P T ;
R E S T A R T C O M P R E S S I O N
1 0 / 1 8 – D / C F R O M S N F T O H O M E
1 0 / 2 1 – H E M E E T S H O M E H E A L T H R N
1 0 / 2 1 – E D V I S I T F O R B L I S T E R S
1 0 / 2 2 – Y O U M E E T M R . S M I T H , D / C
H O M E ; R E Q U E S T P O D I A T R Y F / U 1 D
1 0 / 2 2 – H H R N C O N C E R N E D ; P T C A L L S
P O D I A T R Y & I D ; N O A P P T S A V A I L A B L E
1 0 / 2 2 P M – S E E N B Y S A M E E R
A T T E N D I N G , D / C H O M E
1 0 / 2 3 – S E E S P C P , P O D I A T R I S T , I D
1 0 / 2 7 – S E E S A N O T H E R W O U N D C L I N I C
M D
1 1 / 1 5 – A R R A N G E D F O R V A S C U L A R E V A L

6. REFLECTIONS:
POSITIVES?
NEGATIVES?

7. “HOW MUCH WILL I GET CHARGED
FOR THIS?” (IN THE ED)
Caldwell N, Srebotnjak T, Wang T, Hsia R. “How much will I get charged for this?” Patient
charges for top ten diagnoses in the emergency department. Plos One. Feb 2013, 9(2). e55491.

8. A V E R A G E N O N - S U R G I C A L B A C K P A I N A D M I S S I O N A T
V M ( 7 / 2 0 1 7 - 6 / 2 0 1 8 ) :
4 . 1 D A Y S , $ 1 9 , 0 3 3 ( $ 4 , 7 6 0 / D A Y )
¤
A V E R A G E S E P S I S A D M I S S I O N :
8 D A Y S , $ 5 5 , 2 8 0 ( $ 6 , 9 0 0 / D A Y )
¤
A V E R A G E “ U N C O M P L I C A T E D ” G I A D M I S S I O N :
3 . 7 D A Y S , $ 2 0 , 5 7 0 ( $ 5 , 6 0 0 / D A Y )
¤
T O T A L U N C O M P E N S A T E D C A R E :
$ 3 1 , 5 8 8 , 7 8 6 ( 1 . 4 % ; T H I S I N C L U D E S C H A R I T Y C A R E
A N D “ B A D D E B T ” )
http://www.wahospitalpricing.org/Report_INP.aspx

9. A N N A L S 2 0 0 9 ( B I L L I N G 2 0 0 5 -
2 0 0 6 )
A V E R A G E C O S T O F U R G E N T
C A R E V I S I T ( 3 M O C D D X – O M
P H A R Y N G I T I S , U T I ) :
$ 1 5 5 ( O T H E R S T U D I E S $ 7 1 - 1 2 5 )
H T T P : / / A N N A L S . O R G / A I M / F U L L A R T I C L E / 7 4 4 7 0 2
/ C O M PA R I N G - C O S T S - Q U A L I T Y - C A R E - R E TA I L -
C L I N I C S - O T H E R - M E D I C A L - S E T T I N G S - 3

10. T H E E N D
“ A L I T T L E A T T E N T I O N , A L I T T L E K I N D N E S S , A L I T T L E
T H O U G H T F U L N E S S A R E W O R T H M O R E T H A N A L L T H E
W E A L T H I N T H E W O R L D . ”
― A V I J E E T D A S