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Monday, February 2, 2009

8 theories why hospital census is low

I brought up a while back about how low our census has been. I'm talking extremely low. No one has been laid off yet that I know, but many have been losing hours.

It used to be that business would go in cycles. The ER would be busy during vacation season in the summer, yet we'd have fewer patients admitted.

In the winter it would be the opposite, with fewer ER visits and more elective surgeries and more critical patients being admitted.

Not anymore. I think we've been relatively slow for two straight years, and the past six months we've been so slow it's almost getting to the point we need to worry about losing more hours, and thus burning vacation hours when we don't want to.

So why is it that business is so slow lately. I have a few theories. Perhaps you can add to these:

1. It used to be that cardiac patients were given TPA and then they'd sit in our CCU beds for 4 days. Then they'd go for a cath. the new policy is for a cath to be done ASAP, so all cardiac patients are simply shipped right from the ER.

2. With the economy so bad, no patients are having elective surgeries.

3. With the economy so bad, many potential patients are without insurance. Since they have no insurance they are not coming into the hospital unless they are really sick.

4. Many ER docs are all relatively new to this hospital and may not fully comprehend that we are capable of taking some of the patients they are shipping out.

5. People going elsewhere for their care. People think there are better surgeons and nurses at other hospitals, when that's not necessarily the truth.

6. With the economy of Michigan being the 2nd worse in the U.S., people are moving out of this area. Thus, with a lower population, fewer patients can be expected.

7. DRs are simply not admitting for things they used to admit you for, especially when they know they aren't going to do anything here that you can't do at home.

8. We are doing such a great job with our medical wisdom and new medicines and education that patients stay healthier and don't need to visit us.

A great example of this is asthma. In the 1980s there were plenty of asthmatics to go around. Now we seem to have hardly any asthmatic patients.

As a former asthmatic kid myself, I thought it would be neat to be an RT and work with asthmatic kids. There simply aren't any kids with asthma being admitted.

So these are just some of my theories. I have no idea if it's just this hospital being hit with the low census, or all small town hospitals. I have no idea if larger hospitals have this issue, however I would like to say I doubt it.

If you guys have any theories you'd like to add here, please feel free to leave a comment because my curiosity is peaked.

1 comment:

Glenna said...

That's interesting that you've had low census for 2 years. We're a bigger hospital and still in the summer/winter cycle, although I totally see, too, that a lot of things aren't being admitted for the way they used to be and that the mentality is more "move 'em in, move 'em out" with hospital stays being much shorter than they used to be. Most of that is due to the insurance companies I would think.