To give you a very round number it is several $k per day depending on where in the country ($2-5k) and what hospital for a bed in a two person room with 24h nursing floor care. That does not include doctors, meals, medications, tests, etc. If you're in an ICU or surgery it is easily 2-20x higher than that so you can't compare it. A skilled nursing facility or hospice can be less than $1k per day.
In home care even with 8 to 24h nursing can be had for a similar price or lower than a skilled nursing facility ($50-100/hr) with much better quality of life and lower risk of infection if you go to reasonable efforts to keep it clean.
This doesn't make sense to me. Please correct me if I'm wrong.
A hotel can easily provide room and board (essentially the services of a hospital's basic in-patient care) for <$100 a night. The hospital also has a ton of equipment and staff that are additional, but how can it possibly be as much as $1900-$4900? I feel like in-patient care is similar to a hotel but with extra stuff that might increase the cost by a factor of (perhaps) 2-5. But not 10-25. That would suggest that there's some major inefficiency in hospitals causing the cost bloat. You said the price is before doctors, medications, tests, etc. so the service is essentially just accomodation. How can it be so expensive?
Hospitals have needs that hotels don't from the ground up. They have different architecture, interior design, and HVAC needs, they have different real estate needs, they need to be robust to natural disasters, they maintain services like ambulances and a vast records and bookkeeping system. Sanitation requirements are much higher, there's no reason to assume costs there scale linearly - think about night shifts. Hospital workers usually are more unionized than hotel workers (should a hotel room be <$100 a night?). I believe nurses do a lot of work that lower trained/skilled/paid workers would do in a hotel.
Then you can start throwing in the inflated costs due to the American insurance system, the higher liability hospitals have compared to hotels, and other factors. I'm sure people more familiar with the medical profession could add even more exacerbating factors that I don't know about. All of this isn't to say that the hospital or healthcare system isn't inefficient, but simply that hospitals and hotels are apples and oranges.
Few hotels at the $100 mark has any staff to speak off onsite during the night. A night porter, and a single guy in the kitchen, if there's overnight room service. These people, while probably nice, will be fairly limited in their ability to perform more than the most rudimentary services for you.
You're in hospital because your condition is such that you might need emergency high-grade medical attention on moments notice. If you don't, you're better off going home (or, indeed, checking in to a hotel).
Try to work out what a hotel would cost that would serve you and ten guests en eight course haute cuisine tasting menu from your choice of five different cuisines at 15 minutes notice at any point during the day or night, and you're closer to the answer.
Here in Japan, the health insurance system only covers a basic shared room with other 4 patients. If you want a private room, you have to pay out of pocket. For my wife when she stayed in the clinic for a week after a C-section, the highest grade of room (with your own mini-fridge, etc - comparable to a midrange hotel room) cost 15,000 yen/night ($140/night), which is maybe 2x as much as an actual hotel would cost. Obviously that doesn't include any actual medical (nurse calls etc)
I recently stayed in a Japanese hospital in central Tokyo that's part of a chain used by celebrities. The most expensive rooms were over 1000USD a night, but free rooms are also available (if in limited quantities).
One factor could be that hospitals get reimbursed differently depending on treatment. "Observation" status is low-paying but reliable, whereas "Inpatient" pays higher, but may be deemed unnecessary by an insurance company and thus not paid out. https://www.advisory.com/daily-briefing/2012/08/09/observati...
"Many patients are never informed of their hospital status, and physicians say the care provided does not depend on status. However, the status change can have a major impact on patient costs:
- Hospital stay costs: Medicare pays significantly more for inpatient stays—which fall under Part A of the federal program—than for observation stays—which fall under Part B. As such, much of the cost of a Part B hospital stay fall to the patient.
- Post-discharge care costs: Medicare does not cover post-discharge care for Part B observation stays. As such, a patient who is placed on observation status for a broken bone will have to pay the full cost of rehabilitation. In comparison, Medicare pays for skilled nursing care following an inpatient stay that lasted at least three consecutive days. However, patients who are shifted into inpatient status after spending days in observation status must spend three full days in inpatient status to receive the benefit (the time spent in observation status does not count toward the three-day requirement)."
I am also curious. For further reference, the NHS has a reference cost of £1,489/£3,366 for non-elective and elective inpatient stays respectively (figures date from 2012/13).
As a side question, does anyone know how to convert 2012-GBP into 2018-USD under PPP?
> What’s the relative cost of in-patient vs. out-patient care?
They're not directly comparable, because the care delivered is fundamentally different, but inpatient care is about two orders of magnitude more expensive.
That's not to say that reduction of inpatient care is always a goal, though, because it's only a good tradeoff when the outpatient care actually would provide equivalent or better clinical outcomes. Sometimes that's true, sometimes it's not.
I don't have an answer to your question, but I recently spent some time at the hospital taking care of my daughter, and my understanding is that a lot of it comes down to the fact that hospitals are able to provide good enough care to be comfortable discharging patients earlier.
It used to be more common to keep patients at the hospital just in case, but they now send patients home in many of those cases. In my (unprofessional) opinion, this is a good thing. Recovery is much easier in the comfort of our own home, without the stress of being woken up at all hours of the night for tests. We're also completely avoiding a huge risk -- hospital borne infections.
