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Rehospitalization Rates Suggest Need for Better Planning

Kathleen Blanchard's picture
Rehospitalization Rates

A new impetus to reduce the rates of patient rehospitalization has become a focus of the Commonwealth Fund. A quick turnaround time of readmission to the hospital was found in Medicare claims data from 2003 - 2004, suggesting the need for better discharge planning, patient education, and payment systems that provide hospital incentives to discharge healthier, informed patients.

According to the April 1 report from the New England Journal of Medicine, one in five Medicare recipients find themselves rehospitalized within thirty days of hospital discharge - 51.5% of patients who had been discharged after surgery were rehospitalized or died within the first year after discharge. In addition, half of those who did not have surgical procedures had no physician follow-up prior to being readmitted.

The report on rehospitalization rates also found that Medicare patients are being sent back to the hospital with an unrelated condition that probably should have been addressed before discharge from the hospital. Seventy-three percent of surgical patients were rehospitalized within thirty days with infection, pneumonia, or heart failure. Patients who were hospitalized the longest had the greatest chance of being readmitted to the hospital within thirty days.

The study, "Rehospitalizations Among Patients in the Medicare Fee-for-Service Program," by Stephen Jencks, M.D., M.P.H., Mark V. Williams, M.D., and Eric A. Coleman, M.D., M.P.H, suggests a disconnect between hospitals and physicians, and the current system of healthcare reimbursements.

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Anne-Marie Audet, M.D., Vice President of the Commonwealth Fund says, “Payment reform that provides the right incentives for patient-centered care is a win for everyone. We can improve patients' lives and health, save our health care system billions of dollars, and strengthen the primary care system."

Dr. Jencks says that hospitals and providers must become more patient centered to reduce the frequency of readmission to the hospital. “Patients and families should leave the hospital with a firm follow-up appointment and knowing what to take, what to do, who to call if something unexpected happens, and who they will see and when for follow-up. Doing less is unsafe because, as this study shows, almost all of these patients are high risk—two-thirds will be rehospitalized or die within a year of leaving the hospital." He suggests better collaboration between physicians and hospitals, better discharge planning, and maintaining data measuring hospital performance related to numbers of rehospitalizations, including readmission to other hospitals.

Tomorrow, April 2, The Commonwealth Fund is holding a free Webinar at 2pm., titled “Reducing Rehospitalizations: A National Priority”, outlining strategies to keep rehospitalization rates down.

The study, "Rehospitalizations Among Patients in the Medicare Fee-for-Service Program," drives home the potential cost savings of decreasing rehospitalizations through better discharge planning, and patient education regarding self-care, and payment reform. The result of reducing hospital readmissions would equate to lives saved, improved health among Medicare beneficiaries, and huge reductions in healthcare costs. According to the study, rehospitalizations cost Medicare $17.4 billion in 2004.

Reference: NEJM