It's a fine line, but one worth walking. Hospital and health system leaders should strongly warn against the routine discharge of recovering heart attack patients after they've spent three days in the hospital.
A study appearing in the March 16 issue of the New England Journal of Medicine says the 72-hour discharge strategy is cost-effective for heart attack patients who have no complications.
The concern is that HMOs and other insurers will adopt a general three-day stay, rather than the typical five days or more that most health plans now cover. The situation is reminiscent of the furor created when HMOs tried to limit new mothers to 24 hours of inpatient coverage.
Providers were opposed to that stupid policy, yet they seemed reluctant to lead the charge against the powerful managed-care plans.
They should avoid such ambiguity this time around. Some critics will blast providers for promoting a policy that pads their revenue, but this is a patient-focused issue.
Cost-effectiveness studies will play an increasingly important function in the allocation of healthcare resources, but they shouldn't be wielded as tools to slice patient benefits. This study should be the starting point for debate, not an excuse to further reduce inpatient stays.