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 that 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
The surgeon deliberately inserted the tube just below Nalick's
collarbone, carefully calculating that 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 treatments.
This year, St. John's Mercy Medical Center alone will deliver
home health care to an estimated 62,000 patients in the city of St.
Louis and seven surrounding counties in Missouri. That is double
the patients they served five years ago.
Throughout Missouri, 200 or so more home health agencies find
business just as brisk. Last year, they visited 2.1 million
patients, or about 400,000 more than they did in 1985. That
increase equals 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 a 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 that each lasted five days.
Nalick calculates that 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.
In the hospital, Nalick would have faced intravenous treatments
that left her veins collapsed.
Through home health care, Nalick avoided hospitalization again.
After the chemotherapy, a home health nurse helped her use the same
tube to take medication that drastically cut nausea.
Even patients who do go to a hospital stay fewer days. A
21-year old college student stayed at St. John's Mercy Hospital in
Washington for five days while doctors treated a leg infection.
Back home, he spent two more weeks on intravenous treatment to
combat infection, time he would have once spent in the hospital.
Other patients arrive back in their own bedroom with
respiratory machines, feeding equipment and medical paraphernalia
that lets them inhale drugs or send drugs through their veins.
"People are coming out of the hospital quicker but they are
sicker," said Mary Schantz, who directs the Missouri Alliance for
Home Care. …