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Health district on a roll

Though the Upper San Juan Health Service District is still compiling 2009 year-end data, a general statistical recap suggests Pagosa Mountain Hospital (PMH) remains a beehive of activity, despite low inpatient admissions.

On Tuesday, district finance director Gene Kaberline reported 122 total hospital admissions in 2009, with 104 being general “acute care” patients. Eighteen were swing-bed patients, or patients spending one or more nights in the hospital, after spending at least three midnight stays at an acute care facility, such as Durango’s Mercy Regional Medical Center or the San Juan Regional Medical Center in Farmington.

In most cases, swing-bed patients are those recovering from specialized treatment or surgical procedures received elsewhere, but still require continued attention and monitoring by a Registered Nurse. Too, patients often simply choose to be closer to home during recovery, or the initial facility needs space to accommodate more critical cases.

Of the 122 PMH admissions in 2009, 68 percent were Medicare patients, 5 percent were covered under Medicaid, while 27 percent were listed as “other.” As Kaberline explained it, “other” includes self-pay patients or those with private healthcare coverage.

There were 244 total acute-care “patient days,” with acute-care patients remaining in the hospital an average of 2.35 days. Of the total 118 swing-bed days, swing-bed patients stayed there an average of 6.56 days. Therefore, the overall length of stay for a PMH patient averaged slightly less than three days, while on any given day, there was an average of one patient in the hospital at a time.

In 2009, as in 2008, outpatient procedures accounted for the bulk of hospital activity. Of the 13,610 total outpatients visits last year, 9,606 were non-emergency room visits, or patients receiving blood tests, CT scans, MRIs, or other diagnostic procedures. The remaining 4,004 patients visited the ER for prompt attention to more immediate concerns.

Of the total 2009 outpatient visits, 34 percent were covered under Medicare, while 8 percent qualified for Medicaid coverage and 58 percent were self-pay or privately insured.

In the first 11 months of last year, meanwhile, the district’s emergency medical services (EMS) averaged 85 ambulance calls a month, with an average of 58 total hospital transports. Thirty-two of those transports, or 55 percent of the monthly average, were transported to PMH.

Nurse Practitioner Dan Keuning has seen “under-served, under-insured” patients in the district’s newly-opened Pagosa Mountain Clinic every Tuesday for the past six weeks. The clinic, which is attached to PMH and is a precursor to a planned Rural Health Clinic (RHC) now scheduled to open in the spring. In order to receive required federal certification as a RHC, however, the facility must first pass state inspection, while already providing healthcare services to under-served segments of the community.

Though the clinic hasn’t yet seen the number of visitors district officials had hoped, it has served 39 patients thus far, with 15 returning for follow-up care. To combat what it considers a general lack of public awareness toward the clinic, the district will soon advertise it and available services, while working with the San Juan Basin Health Department to create a voucher program designed to assist those struggling to pay the modest $40-per-visit fee.

In the meantime, early detection and wellness programs continue at PMH each week, with free cholesterol screening every Monday, Wednesday and Friday.

By mid-November 2009, last year’s early detection program, which was funded by a grant from the Colorado Prevention Center, had already provided free or low-cost screening and diagnostic services to 583 people, many with conditions like high blood pressure, excessive weight or substance abuse concerns.

The district is now planning another early detection “week,” including a couple of evening screenings, Feb. 8-13. Free or discounted lab tests and exams will help identify those with physical, nutritional or cholesterol concerns, or those predisposed to diabetes.

As said before, the district’s expanding services and programs now allow community members more timely primary medical care, without crowding Medicare/Medicaid patients into private dispensaries at lower clinic reimbursement levels. Too, they’re sending fewer patients to the hospital ER, while increasing facilities funding and compensation, thereby reducing patient expenses.

chuck@pagosasun.com