.:: Iwan Darmansjah, MD. - Strategic Plannings ::.

.:: STRATEGIC PLANNING ::.

Medical Articles
Category: Case Studies

How Wrong Diagnosis May End Up In High Cost

CASE VIGNETTE: An obese woman, 51 yrs, 74 kg, came on 01/12/09 after escaping the hospital, because the bill was Rp 42 million on the eighth day, which she could not bear.
She was sick, weak, had difficulty to talk and complained of inability to swallow food. When in hospital, she was ‘completely’ examined for all laboratory values, X photos, USG, and lastly MRI. After a couple of doctors’ examination, the working diagnoses were appendicitis, stomach problem, typhoid, fluid in the lungs, kidney disease, etc. Operation was suggested, but the patient refused.
After I took the history it looks like she was suffering from loss of energy and acute malnourishment. Her urine contained keton (++++), which were the result of metabolites from burning body-fat (for energy) instead of sugars. This made the blood and urine acidic, a dangerous condition that needed quick action. I prescribed her fluid food and gave her Diabetasol which was easier to swallow. Two days later she was alive again and keton disappeared.
The clue was that the lady hated rice, but could eat all other food. Cost of ALL was a few hundred thousand Rp, which is roughly 1.5 % of Rp 42 million.

Klik below on the ppt. presentation

Print Article

Send Article

Strategic Planning Categories:
	Strategic Planning For Non-business
	General

Last 15 Strategic Planning:
	Righteousness, Satu Kata Tindakan, Yang Kita Butuhkan Untuk Mengisi Kemerdekaan.
	About Jokes
	Menilai Debat Presiden
	‘harus Bisa!’ Harus Dibaca !
	Mengaktualkan Kebangkitan Nasional
	The Culture Of Eating While Meeting
	Menciptakan Good Governance
	Creating Good Governance (ppt Presentation, 161 Kb)
	Uu Akuntabilitas Untuk Good Governance
	Putting The Good Into Governance In Indonesia
	The Hard Rain That's Falling On Capitalism
	Questions To Be Dealt With Before Marriage
	The Hipo And The Turtle
	Om Bij Stil Te Staan. (author Not Known)
	An Interview With Brian Bacon: Shifting The Currents