As a physician, one of the things not touched on in this discussion and only briefly mentioned in this article is the harm associated with hospitalization. For

As a physician, one of the things not touched on in this discussion and only briefly mentioned in this article is the harm associated with hospitalization. For many of my patients discharge planning is one of the toughest conversations to have. Patients are often reluctant to leave the hospital and I have to tell them why its better that they continue care at home. The reasons they want to stay are many and varied, but include the long emergency department wait times (if they get sick again and have to come back they don't want to deal with that again), clean sheets on a comfortable bed with 3 meals a day for my poorest patients, staff to take care of their needs and that they probably feel safer in the hospital because of all the beeps and bops and scurrying about of the staff. But, they can't see all the patients who had bad outcomes from staying in the hospital too long: they get confused or delirious, there is a medication error, they fall getting out of bed in the middle of the night, they get a new infection, etc. Trying to get people to see those risks is hard, especially since they shouldn't happen, so no one expects them to happen.