美国国家公共电台 NPR--Limited nursing home beds force hospitals to keep patients longer

Limited nursing home beds force hospitals to keep patients longer

Transcript¹

The lack of nursing home beds means that U.S. hospitals are caring for patients who don't need to be hospitalized but have nowhere else to go.

STEVE INSKEEP, HOST:

The nationwide shortage of nursing home staff also means a shortage of care. Nursing homes cannot take on as many residents, and that means many people who should be moving into nursing homes instead spend more time stuck in hospitals. Vermont Public's Nina Keck reports.

NINA KECK, BYLINE²: Kathy Dick is a retired³ nurse who lives in Sudbury, Vt. She remembers when she first began to worry about a close friend.

KATHY DICK: She was taking a couple of us out for lunch, and she couldn't figure out how to pay the bill.

KECK: Her friend was in her mid-70s, had no children and lived alone. Signs of dementia became more frequent, and Dick worried because her friend also had diabetes⁴ and hypertension.

DICK: And it became obvious to me that she was not functioning well and just was deteriorating⁵ before my eyes.

KECK: Her friend ended up in the emergency department multiple times, and long-term care became the only option. But finding an available bed took months. Meanwhile, her friend stayed in the hospital. Kathleen Boyd says this is not a new problem. Boyd directs care management at Rutland Regional Medical Center.

KATHLEEN BOYD: This is a growing concern not just in Vermont but all over the country because people are living longer.

KECK: She says on any given day, they have five to 10 patients waiting in the hospital for long-term care. Not all have dementia; some have serious psychiatric disorders⁶ or are impaired⁷ because of substance abuse or traumatic brain injury. Some may have been homeless, incarcerated⁸ or violent. Boyd says they come to the emergency department for valid⁹ reasons, but once they're stabilized¹⁰, she says insurance won't pay for their care anymore, and long-term care is hard to find.

BOYD: Because the facilities will look at the documentation, and they will say, we don't have the staff to be able to monitor and manage this potentially agitated¹¹ individual.

KECK: While nursing homes can say no, hospitals can't. Many end up caring for patients like this for weeks, months, sometimes even years. With little to no reimbursement¹², it's costing hospitals millions and pushing up health care prices for everyone.

STEPHEN LEFFLER: It's a huge, huge issue.

KECK: Dr. Stephen Leffler is president of the University of Vermont Medical Center.

LEFFLER: I was on one of our floors on Friday rounding, and more than 40% of the patients on one floor were all waiting for nursing home placement.

KECK: That means fewer beds are available for others needing hospital care.

LEFFLER: I'm an ER doctor by training. Nothing bothers me more than people who - their doctors said, you need to go to the academic medical center. And we've said, yes, you do, but we can't take you right now. For most of my career, that almost never happened. It happens every single day now.

KECK: And it's happening at hospitals all over the country. More than 30 medical organizations, including the American Medical Association, wrote an impassioned letter to President Biden last month, calling the situation a public health emergency. Low wages and workforce¹³ shortages exacerbated¹⁴ by the pandemic are at the heart of this problem. Many skilled long-term care facilities have had to hire more costly¹⁵ traveling nurses, straining already tight budgets. That's forced many nursing homes to take beds offline. Medicaid pays for the majority of nursing home patients in the U.S., and a number of states have increased reimbursement rates and provided additional funding. But so far, it's not enough.

For NPR News, I'm Nina Keck in Chittenden, Vt.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。

4 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

5 deteriorating   

恶化，变坏( deteriorate的现在分词 )

参考例句：

• The weather conditions are deteriorating. 天气变得越来越糟。
• I was well aware of the bad morale and the deteriorating factories. 我很清楚，大家情绪低落，各个工厂越搞越坏。

6 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

7 impaired   

adj.受损的；出毛病的；有（身体或智力）缺陷的v.损害，削弱( impair的过去式和过去分词 )

参考例句：

• Much reading has impaired his vision. 大量读书损害了他的视力。 来自《现代汉英综合大词典》
• His hearing is somewhat impaired. 他的听觉已受到一定程度的损害。 来自《现代汉英综合大词典》

8 incarcerated   

钳闭的

参考例句：

• They were incarcerated for the duration of the war. 战争期间，他们被关在狱中。 来自辞典例句
• I don't want to worry them by being incarcerated. 我不想让他们知道我被拘禁的事情。 来自电影对白

9 valid   

adj.有确实根据的；有效的；正当的，合法的

参考例句：

• His claim to own the house is valid.他主张对此屋的所有权有效。
• Do you have valid reasons for your absence?你的缺席有正当理由吗？

10 stabilized   

v.（使）稳定， （使）稳固( stabilize的过去式和过去分词 )

参考例句：

• The patient's condition stabilized. 患者的病情稳定下来。
• His blood pressure has stabilized. 他的血压已经稳定下来了。 来自《现代英汉综合大词典》

11 agitated   

adj.被鼓动的，不安的

参考例句：

• His answers were all mixed up,so agitated was he.他是那样心神不定，回答全乱了。
• She was agitated because her train was an hour late.她乘坐的火车晚点一个小时，她十分焦虑。

12 reimbursement   

n.偿还，退还

参考例句：

• He received reimbursement for his travel expenses.由于出差的花费他可以得到公司的补偿。
• Which forms do I need to complete for my travel reimbursement?我需要填什么表来报我的旅费？

13 workforce   

n.劳动大军，劳动力

参考例句：

• A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
• A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。

14 exacerbated   

v.使恶化，使加重( exacerbate的过去式和过去分词 )

参考例句：

• The symptoms may be exacerbated by certain drugs. 这些症状可能会因为某些药物而加重。
• The drugs they gave her only exacerbated the pain. 他们给她吃的药只是加重了她的痛楚。 来自《简明英汉词典》

15 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。