Reducing health care costs is a prime concern in American health care. One big problem is preventable re-admissions — people who had to return to hospitals after being discharged because of various reasons. Re-admissions are a serious drain on the national health care infrastructure.
More than 4 million preventable re-admissions
Hospitals and health insurers are faced with many problems in the current U.S. health care infrastructure, and one glaring problem is hospital re-admissions. When patients are discharged before they should be, some wind up being admitted to the hospital again. According to the Wall Street Journal, it is estimated that there are up to 4.4 million hospital re-admissions per year that could have been preventable, adding up to about $30 billion of the total national expenditure on health care. That’s about 10 percent of what Americans spend on healthcare. Repeat admissions resulted in the state charging insurers $1.25 billion in 2009 in Pennsylvania alone, according to the Pittsburgh Tribune-Review.
Medicare and Medicaid losing more
Medicare and Medicaid patients are readmitted to hospitals twice as often as patients with private insurance, and the risk appears to be greater for patients between ages 45 to 64. According to a 2008 study by the Agency for Healthcare Quality and Research, Medicare patients between 45 and 64 years of age were readmitted to hospitals for non-maternal reasons twice as often as uninsured patients or patients with private insurance. Medicare patients 45 to 64 who weren’t going to hospitals for any reason relating pregnancy had a readmission rate of 24.1 percent within 30 days. Similar Medicaid patients had a readmission rate of 24.4 percent. Non-pregnancy-related cases in patients 45 to 64 with private insurance had a readmission rate of 11.9 percent. However, there were twice as many admissions for Medicare patients 65 and older than for non-maternal adults with private insurance. Medicare patients older than 65 had an overall readmission rate of 19 percent. More patients with government-funded health care have to go back to the hospital within 30 days of being discharged.
There are a multitude of reasons people are readmitted to hospitals. Medications play a significant part. According to the Centers for Disease Control, adverse drug events account for 700,000 emergency room visits and 120,000 hospital admissions every year, adding up to $3.5 billion in health care spending in total. A fair portion of those involve prescription painkillers. Opioid painkillers such as hydrocodone or oxycodone kill more people by accidental overdose every year than cocaine and heroin combined. Some patients are rushed out the door too quickly, and some may have undiagnosed illnesses. Taking multiple medications increases the risk of an adverse drug event. The CDC estimates that 82 percent of U.S. adults take at least one medication per day and 29 percent take five or more medications per day.
Wall Street Journal: http://online.wsj.com/article/SB10001424052702304474804576369452547349050.html?mod=googlenews_wsj
Pittsburgh Tribune-Review: http://www.pittsburghlive.com/x/valleyindependent/editorial/s_740588.html
Agency for Healthcare Quality and Research: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb115.jsp
CDC on Drug reactions: http://www.cdc.gov/MedicationSafety/basics.html
CDC on unintentional drug poisoning: http://www.cdc.gov/HomeandRecreationalSafety/Poisoning/brief_full_page.htm
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