Bethlen Évkönyv, 1993-1996 (Ligonier)

Kovács Pál: A Bethlen Otthon beszámolója. Egy kis visszapillantás

that, when the reform of the Omnibus Budget Reconciliation Act (OBRA) was implemented, our administrative procedures, the plan of care, almost completely has changed. It was necessary because meeting the needs of today’s care for our residents is more complex than it used to be; the long term care resident is changing. Residents today are sicker and older and require much more care than in the past. The average age of the Bethlen Home resident is 85. The reason they are sicker is that the residents are older. We are dealing with more age-related illnesses such as dementia, strokes, diabetes, heart disease and high blood pressure. Thus expectations are increasing for specialized high-quality care. Quality was always in our mind, but the “heat is on” since OBRA.

The increased requirements implemented on us on every level of patient care, administrative duties and building requirements cost thousands and thousands of dollars. The cost of health care is increasing year by year and it seems to be that while on the Federal and State level they are controlling the health care delivery system, there is no control of cost increases. A shocking statistics state that nationally, health care expenditures by the government, private insurers, and ordinary people increased 163% from $230 billion in 1980 to $606 billion in 1990. That means for example, that health care spending in the United States per citizen is three times what is spent in Great Britain, twice what is spent in Japan and 38% more than Canada. For all of our spending, our life expectancy is no better than those three nations, and the United States infant mortality rate is higher than those nations.

And now we are facing again the new Healthcare Reform Proposal from President Clinton. Nobody really can forecast the outcome. We were alerted only that fundamental change can be expected in long term care. These changes will range from expanded home and community-based services to the opening of the subacute care for skilled care facilities. Mrs. Hillary Clinton just recently said that nursing homes should play a larger role in providing subacute services. “Many doctors keep patients in hospitals for longer than they should,” she said, “and better to provide reimbursement for subacute care in nursing homes than in the much more expensive hospital setting.”

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