Top 5 Reasons for Hospital Readmissions, and How to Prevent It

A recent study conducted by The Dartmouth Institute found that one in six Medicare patients is readmitted to the hospital within 30 days after being discharged. And more than half do not see their doctor within two weeks after leaving the hospital.

The researchers analyzed the hospital records of 10.7 million Medicare patients and found, “widespread and systematic failures in coordinating care for patients after they leave the hospital,” said David C. Goodman, M.D., M.S., lead author and co-principal investigator for the Dartmouth Atlas Project. “Irrespective of the cause, unnecessary hospital readmissions lead to more tests and treatments, more time away from home and family, and higher health care costs.”

According to CMS the costs associated with avoidable readmissions exceed $17 billion a year. To combat this, Medicare will begin implementing plans in 2013 to reduce these costs by imposing penalties on hospitals with excessive readmission numbers. The penalties are based on the hospital’s total Medicare billings and will start at one percent in 2013, then increase to two percent in 2014, and three percent in 2015. “The need to develop more efficient systems of care that include discharge planning and care coordination is clear,” said Elliott S. Fisher, M.D., M.P.H., report author and co-principal investigator of the Dartmouth Atlas Project. When confronted with the threat of considerable financial risk, Medicare hopes hospitals will take the steps necessary to improve their systems of care and reduce readmissions.

Top 5 reasons for patient readmissions

In a companion piece to this study Dartmouth published Care About Your Care, which lists some of the reasons patients are readmitted. The top five:

  1. Patients may not fully understanding what’s wrong with them
  2. Patients  may be confused over which medications to take and when
  3. Hospitals don’t provide patients or doctors with important information or test results
  4. Patients do not schedule a follow up appointment with their doctor
  5. Family members lack proper knowledge to provide adequate care

 
Regardless of the cause, preventable readmissions are costing billions of dollars a year, and Medicare patients are hit especially hard. The good news is there’s a lot you can do to avoid having to be readmitted to the hospital. Forgive us for inserting a sports analogy, but this truly is a case of, “the best defense is a good offense.” You can go on the offensive and take steps that will greatly increase your chances of a positive outcome. And it’s not that difficult. There are plenty of people and resources to assist you.

Here are some things you can do to prevent being readmitted to the hospital.

First, do a little research and learn about the type of health care provided by different hospitals in your area. The U.S. Department of Health and Human Services has a website that can help you research and compare hospitals at www.hospitalcompare.hhs.gov. There’s also a report from the Dartmouth Atlas Project called, After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare Beneficiarie. This report examines “how effectively communities and hospitals coordinate care for patients when they leave the hospital.”

After you’ve picked the best hospital, what should you do to help ensure you won’t have to be readmitted?  As with many things, success here begins with proper planning. Before you leave the hospital create a written discharge plan. It should contain all of the information you, or anyone who will be taking care of you, will need to make sure you get proper care. Doing so can help reduce your risk of being readmitted. Your plan should include things like your discharge date, follow-up appointments, phone numbers, medications, homecare/homehealth and a host of other things. Your hospital may have someone on staff that can help you, or you can use one of the planning check lists that you can download from the Internet. Here are two that you might find helpful:

Taking Care of Myself: A Guide for When I leave the Hospital: www.ahrq.gov/qual/goinghomeguide.pdf

Your Discharge Planning Checklist: For patients and their caregivers preparing to leave a hospital, nursing home, or other health care setting: www.medicare.gov/publications/pubs/pdf/11376.pdf

It’s important to go through your planning check list thoroughly and write everything down so you and others can refer to it when necessary. Remember to review it with your doctor and/or health care staff before you leave the hospital to make sure the information it contains is complete and accurate. And start early; there’s no reason to wait till just before you’re released.

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