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Twenty Percent Of Medicare Patients Readmitted Within Month

Posted on: Thursday, 2 April 2009, 06:55 CDT

Researchers found an alarming situation in Medicare patients who often return to the hospital within a month of discharge. It’s a practice that costs taxpayers billions of dollars a year.

One in five Medicare patients end up back in the hospital, and the new study suggests patients aren't told enough about how to take care of themselves and stay healthy before they go home.

The study found that half of the non-surgery patients who returned within a month hadn't even seen a doctor between hospital visits.

"Hospitals put more effort into the admission process than they do into the discharge process," said Dr. Eric Coleman, one of the study's authors from the University of Colorado in Denver.

Coleman, who runs a program to improve "hand-offs" between health care systems, said patients often become confused about how to take their medicine or run into other problems. He believes they head back to the hospital because they don't know where else to go for help.

President Barack Obama's budget is focusing on the problem as it calls for reduced spending on Medicare readmissions to pay for health care reform.

The findings are published in Thursday's New England Journal of Medicine .

Researchers studied Medicare records from late 2003 through 2004. They found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge; about a third were back in the hospital within three months.

Overall, patients with heart failure and pneumonia had the most readmissions while heart stents and major hip and knee surgery had the highest returns for surgical procedures.

The study noted that 10 percent of all readmissions were probably planned, such as putting in a stent.

They estimated that the cost of unplanned return visits in 2004 cost taxpayers $17.4 billion.

"It's a big hunk of money and it's a big hunk of misery," said another study author, Dr. Stephen Jencks, an independent consultant who worked for the Centers for Medicare and Medicaid Services.

Jencks suggested hospitals should help make follow-up doctor appointments, give patients a list of all their medications, and explain what to do at home and where to call if they run into problems.

He said the hospitals should also call the patient within two days and make sure that the patient's doctor knows they were in the hospital.

There are differences among states. Iowa had the lowest rate with 13 percent, while Washington, D.C., had the highest at 23 percent.

Dr. Brian Jack at Boston Medical Center said there is an alarming example of how misinformation can hurt patients. One woman didn't understand that the blood pressure medicine that the hospital told her to take was the same as the one she had at home - just with different names. She took both and returned to the hospital with kidney failure.

Jack and his colleagues tested a new checklist that nurses used when they sent patients home; the patients who used the checklist had 30 percent fewer visits to the emergency room or return hospital stays over the next month, compared to patients who didn't use it

"There are not too many things that improve health and save money," said Jack, who was not involved in the new research.


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University of Colorado Denver

Source: redOrbit Staff

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