Abstract
With a goal of increasing transparency regarding the utilization of Observation Units (OUs) in relation to Medicare policies, a 2012-2014 retrospective analysis was performed on 108 009 de-identified records of patients admitted from emergency departments to OUs within an urban health system. A cost-benefit analysis of OUs from the patient-centered perspective provided the theoretical patient cost. Using a query search, data regarding encounter type, length of stay, insurance carrier, origin, disposition, and age were collected. The 2016 Health Care Cost and Utilization Report was used as a means to extrapolate cost. The results showed that Medicare patients with Part B coverage were expected to pay between $516.80 to $548.20 for the average OU stay. Patients needing care in a skilled nursing facility post-OU discharge, without a 3-day qualifying stay, incurred a charge of $6244 to $6402. There is reason to investigate the policies regarding patient education and notification surrounding OUs. In an effort to improve care delivery and patient satisfaction, health care clinicians must partner with patients to improve health education and empower patients to manage their own care.