By Phyllis Brasch Librach and Robert Kelly Of the Post-Dispatch
St Louis Post-Dispatch (MO)
EVERY FIVE MINUTES, between bites of home-cooked food and friendly conversation, Shari Nalick fed her body doses of toxic drugs. No one at the dinner party ever suspected Nalick sat at the table undergoing chemotherapy for breast cancer.
The liquid medication poured from a small reservoir belted to Nalick's waist on a fanny pack. On cue, a miniature computer released drugs that flowed through a pencil-thin tube to a vein in Nalick's chest.
The surgeon deliberately inserted the tube just below Nalick's collar bone carefully calculating her dress neckline would neatly conceal a bandage the size of a postage stamp.
Just five years ago Nalick would have sent regrets to the host because she had to be hospitalized for chemotherapy. Today, Nalick and other cancer patients get chemotherapy at home and the chance to keep up their lifestyle.
Everyday health care gets delivered to the home address of more and more patients throughout the metro area who once were hospitalized for the same treatment.
"Patients have a lot more control over their treatment at home, and research shows that patients get well quicker in their own homes," says Paula Bull, unit director for home health care at St. Anthony's Health Center in Alton.
She said her unit's 34 staff members provide home health care for about 300 patients within a 35-mile radius of St. Anthony's in southwestern Illinois. That represents an annual growth rate of about 20 percent for the last five years, Bull said.
She said home care is becoming more attractive to patients because "it's the most cost-efficient way to get care." She added, "I understand that it's going to be a big component of President Clinton's health-care reforms."
Bull noted that not all patients can get home care, because it requires a fair amount of support from families and friends. Even so, those who receive the care from her unit rarely complain, she said.
Her staff conducts annual surveys of patients about their home care. "I don't think I had any negative written comments last year (from patients) at all," she said.
Bull read these responses from some survey forms:
"Your care, concern, teamwork and enthusiasm are great. Keep it up!"
"All of the nurses were very professional, and all became very good friends."
"I looked forward to the nurses coming each day."
"It was heartwarming to know that others care."
This year, St. John's Mercy Medical Center delivers home health care to 62,000 patients in the city of St. Louis and seven surrounding counties in Missouri. That is double the patients served five years ago.
Throughout Missouri, two hundred or so more home health agencies find business just as brisk. Last year they visited 2.1 million patients or 400,000 more than they did in 1985. That increase alone equals almost the population of the city of St. Louis.
Why the push to provide health care at home instead of the medical center? Hospitals, insurance companies and the federal government want to save money. The math is simple. It costs less to deliver health care to the patient's front door than to keep the patient in the hospital.
For example, a nurse from an area hospital got paid $125 for each visit she made to Nalick's home in Chesterfield. State health officials recently calculated a typical hospital stay costs $1,510 a day. That adds up to a $62,325 savings based on Nalick's nine chemotherapy treatments, each lasting five days.
***** A Break Beyond Bucks
Nalick calculates the home treatment also cut disruption to her everyday life. With her fanny pack strapped around her waist, Nalick slept in her own bed, saw friends at social events, cooked her family meals and went to PTO meetings. When the treatment left her hungry and thirsty, she opened the refrigerator and pantry for her favorite snacks. …