Avoiding the Next Hospital Readmission
Written by Chris Austin, My Life LLC
Most adults over the age of 65 don’t relish the idea of being admitted to the hospital. What’s worse is the thought of having to be readmitted again within a short period of time. Unfortunately, for many Medicare recipients over the age of 65, this is a common phenomenon that healthcare professionals kindly refer to as ‘the revolving door’.
Until recently, little data existed to track the prevalence of avoidable hospital readmissions in the United States. However, last year a study was published in the New England Journal of Medicine that set federal regulatory agencies to the task of fixing what has now become a nation-wide healthcare problem. According to the study, 1 in 10 Medicare recipients over the age of 65 is avoidably readmitted to the hospital within 30 days after their discharge. And the chances for an avoidable readmission increase over time. In fact, 1 in 4 older adults experience a readmission within 3 months, and 1 in 2 patients will experience a readmission within a year.
Why are these numbers so concerning to consumers and healthcare professionals? Readmissions are costly to individuals and to Medicare. A Medicare recipient will pay on average $1,600 out-of-pocket for every hospital admission. This can add up to thousands of unnecessary dollars spent per year. Medicare calculates that it will spend billions of dollars annually on avoidable readmissions. In addition to the financial costs, consumers and their families experience emotional and physical distress when they find themselves caught in the ‘revolving door’.
Research shows that causes for readmissions are linked to shortfalls within the healthcare system and choices that patients make. For instance, studies suggest that most patients who are readmitted within 30 days of their hospital discharge have no contact with their primary care physician in between admissions. This might be because patients don’t realize that they need to see their regular doctor, or they aren’t able to get an appointment in a timely manner. Some patients may simply choose not to see their primary care physician despite hospital discharge recommendations.
The answer to avoiding an unnecessary hospital admission involves improved communication and better coordination of care. Having a solid discharge plan that patients understand is vital. Healthcare professionals must pay special attention to patients who have chronic diseases such as congestive heart failure, diabetes and renal disease, because they are at greater risk for being readmitted. Patients should ask questions when they do not understand what they must do in order to manage things once they return home.
Health insurance companies, hospitals, home health agencies and other community programs offer services free of charge that support patients who are at risk for readmission. When these services do not offer enough support, consumers can privately purchase the services of a geriatric care manager who can provide oversight and guidance. Consumers should inquire with their healthcare provider about potential services that may be available. Or, a listing of geriatric care managers is available at www.caremanager.org.
Chris Austin is president of My Life, LLC Professional Geriatric Care Management. She is one of only a few geriatric care managers in the Twin Cities who is certified by the National Association of Professional Geriatric Care Managers. She provides education and training to consumers and healthcare professionals. For more information please visit www.mylifecarellc.com, or call 612-396-5473.