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Observation Status for Hospitalized Patients

Observation Status for Hospitalized Patients Hospitalized But Not Admitted Original Investigation Research Invited Commentary A Maddening Policy Begging for Revision Robert M. Wachter, MD “But I don’t want to go among mad people,” Alice remarked. In this issue of JAMA Internal Medicine, a team of inves- “Oh, you can’t help that,” said the Cat: “we’re all mad here. I’m mad. tigators from the University of Wisconsin demonstrate just how You’re mad.” far observation status has drifted from its sensible origins. Al- “How do you know I’m mad?” said Alice. though the data come from a single academic medical center, “You must be,” said the Cat, “or you wouldn’t have come here.” they ring true from my experiences at both academic and com- Lewis Carroll, Alice in Wonderland munity hospitals. “Well defined set of specific…services,” reads Medicare’s When I was a resident at San Francisco General Hospital, the policy. Yet Sheehy and colleagues found that among the 4578 very busy Emergency Department had an “observation observation stays in their study, there were more than 1000 unit”—an adjacent room in which patients could receive ad- diagnoses, as determined by billing codes. Only “rare and ex- ditional diagnostic tests or therapies before it was deter- ceptional cases” http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Observation Status for Hospitalized Patients

JAMA Internal Medicine , Volume 173 (21) – Nov 25, 2013

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Publisher
American Medical Association
Copyright
Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.7306
pmid
23835681
Publisher site
See Article on Publisher Site

Abstract

Hospitalized But Not Admitted Original Investigation Research Invited Commentary A Maddening Policy Begging for Revision Robert M. Wachter, MD “But I don’t want to go among mad people,” Alice remarked. In this issue of JAMA Internal Medicine, a team of inves- “Oh, you can’t help that,” said the Cat: “we’re all mad here. I’m mad. tigators from the University of Wisconsin demonstrate just how You’re mad.” far observation status has drifted from its sensible origins. Al- “How do you know I’m mad?” said Alice. though the data come from a single academic medical center, “You must be,” said the Cat, “or you wouldn’t have come here.” they ring true from my experiences at both academic and com- Lewis Carroll, Alice in Wonderland munity hospitals. “Well defined set of specific…services,” reads Medicare’s When I was a resident at San Francisco General Hospital, the policy. Yet Sheehy and colleagues found that among the 4578 very busy Emergency Department had an “observation observation stays in their study, there were more than 1000 unit”—an adjacent room in which patients could receive ad- diagnoses, as determined by billing codes. Only “rare and ex- ditional diagnostic tests or therapies before it was deter- ceptional cases”

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Nov 25, 2013

References