M4A3

M4A3
Q1a. What are the nationwide average length of hospital stay and average cost for patients with the following diagnoses?
Diagnoses Average length of hospital stay Average cost for patients for the following diagnoses
Abdominal pain 5.1 44054
Acute Myocardial Infarction 4.5 81197
Chronic Obstructive Pulmonary Disease and Bronchiectasis 4.2 30015
Diabetes Mellitus and Complications 4.7 38572
Q1b. What are the nationwide average length of hospital stay and average cost for patients with the following diagnoses?
Diagnoses Average length of hospital stay Average cost for patients for the following diagnoses
Cesarean Section 3.4 22727
Hip replacement (total and partial) 3.5 61673
Hysterectomy (abdominal and vaginal) 2.6 38618
Percutaneous coronary angioplasty 3.5 84813
Q2a. What are the Western Province (California) average length of hospital stay and average cost for patients with the following diagnoses?
Diagnoses Average length of hospital stay Average cost for patients for the following diagnoses
Abdominal pain
(Categorized as other disorders of the Gastrointestinal system) 4.8 55818
Acute Myocardial Infarction 4.2 107041
Chronic Obstructive Pulmonary Disease and Bronchiectasis 4 43476
Diabetes Mellitus and Complications 4.4 50433
Q2b. What are the Western Province (California) average length of hospital stay and an average cost for patients with the following diagnoses?
Diagnoses Average length of hospital stay Average cost for patients for the following diagnoses
Cesarean Section 3.

4 27227
Hip replacement (total and partial) 3.5 75080+
Hysterectomy (abdominal and vaginal) 2.7 46706
Percutaneous coronary angioplasty 3.5 99432
2. The UM Committee of a hospital discovered that the rate of caesarean section (CS) was higher in that hospital compared to the rate of vaginal delivery. The committee wanted to evaluate the medical necessity of caesarean section based on the most current recommendations. The recommendations were searched from the National Guideline Copyright 2013. The summary of the guidelines are as follows:
a. Women having uncomplicated singleton breech pregnancy at term in whom external cephalic version is contraindicated or unsuccessful should be extended CS. CS will reduce the risk of perinatal and neonatal morbidity.
b. In twin pregnancies, where the first twin is not cephalic, CS should be extended.
c. CS should be extended in cases of preterm birth and “small for gestational age”. This is because preterm birth and “small for gestational age” increases the risk of perinatal and neonatal morbidity.
d. Placenta Praevia and Morbidity Adherent Placenta (low lying placenta confirmed at 32 to 34 weeks of gestation) are other indications for recommending a CS.
e. CS should also be implemented if the mother (HIV infected) is not receiving any anti-retroviral therapy.
3. The UM practices that my health insurance company (Medicare) follow to control costs and ensure provision of clinical services that are necessary are:
I am enrolled in the original Medicare plan. The plan consists of two parts. In type A, I do not need to pay the premium as I have taxes deducted for my Medicare (Part A) coverage. On the other hand, I am liable to a deduction of 166 U.S. Dollars for paying the premium for Part-B of the plan. The costs cover my in-patient stays in major hospitals in the United States. However, I would not be reimbursed if I am discharged within 24 hours. On the other hand, I would be entitled to receive surgical interventions at predetermined rates under Medicare provisions. I would also be eligible to receive reimbursements on prescription drugs for my ailments. However, from 2016-217 there would be restrictions on coverage of occupational therapy, speech-language therapy and physical therapy.