It’s one thing for hospitals to be responsible for the quality of medical care that takes place within their walls. But how much blame should they bear for the fact many patients end up coming back to the hospital not long after they left?
Some 20% of Medicare patients discharged from the hospital are readmitted within a month, and 34% return within three months, according to a study published in the current New England Journal of Medicine. Unplanned rehospitalizations cost Medicare $17.4 billion in 2004, the study says.
What are the reasons why so many patients bounce back… discharged too early? Inappropriate follow up? Poor discharge instruction? The patients are simply very sick? The correct answer is probably a combination of all of the above. Because of the way hospitals are reimbursed there is a significant incentive to discharge patients home. There is very little if any follow through with patients after discharge. With our siloed method of care, many primary care docs probably don’t find out that their patient was discharged until the patient calls for follow-up.
As most of you already know, many Fortune 100 companies are investing in the home health market. http://tinyurl.com/dkezjd Why do I mention this? Home health monitoring and incentivizing both the patients and providers to actively participate in these programs will probably result in a decrease in admission rates in the first place; and certainly result in lower rate of re-hospitalization on the back end.
I imagine that CMS will try and penalize hospitals for readmissions ??? All that will accomplish is longer hospital stays, which will result in a higher incidence of hospital acquired pneumonia, UTI, DVT, costs, etc. It will do NOTHING to deal with the reason why the patient was re-admitted to hospital in the first place.
This is simply another reason why we need to support true HC reform, and enable the HC sector innovators to help put systems in place to monitor these patients, predict admission trends and encourage intervention before these patients need to go to the hospital in the first place.