Preventable Hospital Readmissions Continue to Pose Problem

February 14, 2013

More than 1 million Americans wind up back in the hospital only weeks after they left for reasons that could have been prevented -- a revolving door that for years has seemed impossible to slow. Now Medicare has begun punishing hospitals with hefty fines if they have too many readmissions, and a top official says signs of improvement are beginning to emerge, says the Washington Post.

  • Nearly 1 in 5 Medicare patients is hospitalized again within a month of going home, and many of those return trips could have been avoided.
  • But readmissions can happen at any age, not just with the over-65 crowd who are counted most closely.

Where you live makes a difference, according to new research that shows how much room for improvement there really is. Consider, according to a report from the Dartmouth Atlas of Health Care:

  • Some 18 percent of nonsurgical patients, the highest rate, are readmitted within a month in the New York City borough of the Bronx.
  • Rates are nearly that high in Detroit, Lexington, Ky., and Worcester, Mass.
  • Yet the readmission rate in Ogden, Utah, is just 11.4 percent.
  • Half a dozen other areas -- including Salt Lake City, Muskegon, Mich., and Bloomington, Ill. -- keep those rates below 13 percent.
  • For surgical patients, Bend, Ore., gets readmissions down to 7.6 percent.

Rehospitalizations cost more than $17 billion a year in avoidable Medicare bills alone. Make no mistake, not all readmissions are preventable. But many are, if patients are given the right information and outpatient support.

  • The new Dartmouth Atlas evaluated Medicare records for 2008 to 2010, the latest publicly available data, to check progress just before Medicare cracked down.
  • In October, the government began fining more than 2,000 hospitals where too many patients with heart failure, pneumonia or a heart attack had to be readmitted in recent years.
  • Of seniors hospitalized for nonsurgical reasons, 15.9 percent were readmitted within a month in 2010, barely budging from 16.2 percent in 2008.
  • Surgery readmissions aren't quite as frequent -- 12.4 percent in 2010, compared with 12.7 percent in 2008. That's probably because the surgeon tends to provide some follow-up care.

Some studies suggest part of the variation is because certain hospitals care for sicker or poorer patients, especially in big cities. Yet Minneapolis, for example, has readmission rates just below the national average. Whether local doctors' stress outpatient care over hospitalization, and how many hospital beds an area has play big roles, too.

Source: "Aging America: Myriad Roadblocks to Recovery Fuel Hospital Readmissions, Geography a Factor," Washington Post, February 10, 2013.

 

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