Overstays cost Hawaii hospitals $63 million a year

HONOLULU — Patients who no longer need acute medical care but remain in Hawaii hospitals cost those facilities nearly $63 million a year, says a study released Wednesday by the Hawaii Health Information Corporation.

These “waitlisted” patients stay too long at hospitals because they don’t have access to specialized care anywhere else. Cheaper options often aren’t available in Hawaii for patients who need special equipment for treatment, who suffer from mental illnesses or who could be treated in a nursing home with a specialist. That leaves hospitals to fill the cost and care gap.

The nonprofit HHIC collects and analyzes the state’s health data. The study examined records from Hawaii’s 15 acute care hospitals from 2006 to 2011.

Two-thirds of waitlisted patients in Hawaii are covered by Medicare. They often wind up using expensive hospital resources that the government insurer doesn’t cover, leaving hospitals to make up the difference. Collectively, the hospitals lost an average of $1,259 per day on the 7,055 patients the study included. Those patients averaged a week on the discharge waitlist before they left the hospital.

The expense of waitlisted patients is a unique problem for Hawaii, said Peter Sybinsky, the CEO and president of HHIC. Because the state’s hospitals are nonprofit or state-run, patient welfare often comes at the expense of profits.

“They have their patients’ interests at hand,” Sybinsky said. “A for-profit hospital may not keep a person on a waitlist if they’re not going to get paid for it.”

Other states also may have more alternatives to hospitalization, such as better mental health treatment or nursing homes with specially trained nurses, Sybinsky said.

Septic infections, skin infections, tracheostomies and head trauma were among the leading maladies afflicting waitlisted patients.