Patient re-admission is as common as it is expensive
Patients bouncing back into the hospital are killing the American healthcare system. (Photo Credit: CC BY/R.D. Moeser, JOC, USN/Wikipedia)

Many Americans are wondering if health care reform will be enough to offset the massive financial burdens that have plagued the nation’s health care system for the past few decades. Preventative medicine would ideally keep people out of hospitals, but the sad truth is that Americans on Medicare are re-entering hospitals nearly as quickly as they’re discharged. According to a 2009 study by the New England Journal of Medicine, one-fifth of Medicare patients are readmitted to the hospital within 30 days of discharge. After 90 days, that percentage increases to one-third. Startlingly, after one year, two-thirds are either readmitted or they die.

Constant re-admission is a tremendous financial drain

The Huffington Post reports that Medicare cost taxpayers $17.4 billion in 2004. That tremendous cash outlay prompted Medicare administration to begin to monitor hospital re-admission rates. Those with high re-admit rates are financially penalized. This threat created a new industry, where companies would extend their services to those hospitals in need of improvement. As various studies show that 75 percent of re-admissions are preventable, there appear to be many avenues through which hospitals could enact improvements in patient care.

Hospitals and nursing facilities point fingers at one another

Lack of communication between acute care hospitals and skilled nursing facilities is a common thread in just how likely a patient is to avoid rebounding back into care. Not providing enough patient and medication info, neglecting follow-up appointments and providing confusing or contradictory patient care instructions are just some of the major problems America’s health care system faces, writes the Post. Older patients on Medicaid who are passed back and forth between care facilities tend to be the most vulnerable victims caught in the crossfire.

How Medicare and private insurance may be hurting themselves

The Huffington Post cites an American Geriatric Society study that shows that Medicare and private insurance companies are “pushing very hard” to have stroke rehab patients admitted to skilled nursing facilities rather than inpatient rehab centers. Doing so is less expensive upfront, but the rebound rate is 14.3 percent at the former, while the more intensive care given at inpatient rehabilitation facilities results in only a 2 to 3 percent re-admission rate. Couple the obvious cost difference with the proven statistical fact that patients who enter inpatient rehab facilities after a stroke are three times more likely to return home after care and the lack of vision on the part of Medicare and private insurance becomes particularly disturbing.

Always question your doctor

Left to their own devices, medical facilities will work to move patients out of care as quickly as possible. This is why it is vitally important that patients (Medicare or otherwise) and their loved ones question doctors regarding the risk of re-admission, and to make sure they understand the necessary care going forward. See the Huffington Post article below for more specific info on what questions to ask your doctor.

Dr. Ian Scott on how to reduce hospital re-admissions

Sources:

Huffington Post http://www.huffingtonpost.com/richard-c-senelick-md/the-bounce-back-effect-ho_b_677575.html

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