treatment determined by cost?

[violetqueen]

Ok ,have posted here about problems of 90 year old mother being discharged from hospital following hip replacement .
Hospital found low sodium levels ,rising pottasium and have asked GP to review.

GP ,who has yet to visit ,but has had blood tests done and is concerned , now suggesting out patient treatment at day hospital .
My question is ,would it be unreasonable to request that he arranges weekly blood tests at home - DN is already visiting daily to dress an ulcer and adminster anticoagulant injection ?
This would be much less stressful for mother ,who frankly isn't well .
I'm just wondering if the home blood tests would somehow come out of GP's budget ,while day hospital wouldn't .
And influence how strongly I may need to make a case ?

I think the problem is that the DN wouldn't be carrying around all the blood test vials, and then any samples would be sitting in her hot car for her to take back to the surgery etc for them to then go to the lab.

It may also be that day hospital will be able to access physio, OT etc for her whilst she is there

I think it is reasonable to ask the GP, who probably has very good reasons, why weekly blood tests are not being done - instead of going in all guns blazing accusing him of risking someone's health to save some money. Also check with the nurse, who might not be willing to take the bloods.

Perhaps with the anticoagulant he doesn't want to risk too many needles in her veins outside a hospital setting, perhaps there is no point in further tests until she has had some treatment or he would like a specialist to monitor BP and things as well.

I doubt that it would be a cost consideration. Day hospital treatment will be much more expensive than the cost of a weekly blood test.

Thanks everyone .
I'm not an all guns blazing type of person .If I were then maybe I wouldn't have accepted GP's initial refusal to my request for a home visit for 90 year old who due to hip op 5 days earlier can only manage few steps with a zimmer ( plus very ,very breathless ) plus told by physio not to use car because seats too low .
His response to this explanation about recent hip op and age was " So what ? We can see 6 patients in surgery in time it takes for one home visit ."

Sorry, this was the first post I had seen so didn't know the background with the GP - he sounds awful. Is there no other GP at the practice you could switch to? Getting the nurse on side and talking things through with her might still be a good first step though, especially if she treats similar patients.

DNs can take blood, and often do for chemo patients. They incorporate trips back to drop off samples. Ask, certainly. But it won't be cost.

Thanks guys .
I was shocked by GP's refusal to do a home visit ,but I could see the sense of what he was saying and he did phone me when he'd got the blood results .
Though scared the life out of me and left me worrying all weekend .
Anyway he's seen her today so I feel much relieved of responsibilty and reassured that he's checked her out a bit ( though she was having a good day ,she does seem to vary rather a lot ) .
He's taken more bloods and will decide more when he has results .

I think GP thinking kidneys ..
I did ask whether the surgery might have contributed to problem and he seemed to think not .

Well kind of hard to say as my mum doesn't share much and is anxious to put on a good show .
But I would say that this has been going on for some time ,it's just that recent hospitalisation has highlighted it .
From state of her toilet bowl ( she has poor eyesight and doesn't notice it needs cleaning ) I would say that explosive diarrhoea is not unusual ,but not all the time .
Yes ,she's weak - but is 90 ,has irregular heart beat .
The confusion thing is tricky - she is still doing crosswords ,but she has seemed a bit muddled recently .