I recently accepted a position on adjunct faculty at Duquesne University teaching a Differential Diagnosis course. Within the text I am utilizing for the course, I came across the phrase “Quicker and Sicker“, to describe the current landscape of US healthcare (its actually not a new concept and has been around for around 25 years). In a nutshell, this term indicates patients are being discharged from our hospitals more rapidly, making them more unstable in their post-acute care environment. This leads to the increased necessity for competence in medical screening by those who may interact with them after point of discharge.
While the concept is not new in the United States, I was struck to learn that the clinical culture is much different in China.
See my current class includes a group of students from Shanghai, who are completing a graduate degree in rehabilitation sciences. While discussing this topic, they were shocked to learn that “same-day” surgeries exist in the United States. They stated in China, you will be hospitalized for 1-2 weeks following a total joint replacement, 2-3 days following a rotator cuff repair, etc. During this time, your care is monitored closely by the physician and rehabilitation begins in the hospital.
So what is best approach to care? From my understanding, this is quite a complex question that involves everything from culture to payment models and a load of variables in-between.
In all of this I’m wondering…Do you suspect the landscape is becoming “too quick” and discharging patients who are “too sick”?
Categories: Critical Thinking