Preadmission Screening of Medicare Patients

Abstract

<h3>To the Editor.—</h3> The article entitled "Preadmission Screening of Medicare Patients"¹did not address an important issue that I feel must be considered when discussing the effectiveness of such a program. What is the cost of preadmission screening? Using data from the article, one could surmise that at least 115 000 telephone calls are received per year. I would like to know how many nurse reviewers, physician reviewers, and secretaries are needed to staff the program. What is the cost of the office rental and supplies? On a yearly basis, one could expect about 400 admission denials, with about half of these patients eventually being admitted anyway. If the program costs $1 million per year to run, each true denial will result in a $5000 expenditure. Of course, I ignore the cost of wasted man-hours on the part of practicing physicians and their personnel while repeatedly dialing the telephone