Vishal Makhija was put onto a special medical plane at LAX today for a flight home to Mumbai, almost nine months after he was seriously injured by a hit-and-run driver in Boyle Heights. Los Angeles County is paying the $19,200 cost of the flight — and considers it a bargain. Makhija, 32, had been filling a bed at County-USC Medical Center all this time, and the flight costs less than keeping him in a hospital bed for the foreseeable future. From the Zev Yaroslavsky news website:
Makhija’s case represents an innovative effort by top county health officials to reduce hospital costs while improving patient outcomes for large numbers of hard-to-place indigent patients who are taking up public hospital beds longer than medically necessary.
Dr. Mitchell Katz, director of the county’s Department of Health Services, says he hopes to create a special fund in his budget for “creative discharges” like Makhija’s that, with some imagination, could be solved in ways that do right both by the individual patient and by the county’s limited pool of health care resources.
“Of course, each case is different,” Katz says. “There isn’t a cookie-cutter solution.” Housing and special placements have their own price tags, he notes, and sometimes the circumstances and the medical needs will make the hospital the most cost-effective decision.
“You have to look at each person and figure out what they need,” he says. “But once you’ve figured that out, if there’s a solution that’s substantially less expensive, you should be able to move on it.”
Dr. Christina Ghaly, LAC+USC’s interim chief executive, says that on any given day, approximately 10% of the hospital’s acute care medical beds, and about half of its acute care psychiatric beds, have been occupied for weeks or months by patients who should be in a lower level of care but have no provider willing to take them.