"A report released today says the cost of patients returning to hospitals within 30 days of a stay—known as readmissions—is costing the state (New York) $3.7 billion each year." - read the Morning Call article
Reducing Hospital Readmissions in New York State
At least four factors are widely viewed as important to effective discharge planning:
(1) coordination between the hospital-based and primary care physician,
(2) better communication between the hospital-based physician and the patient,
(3) better education and support for patients to manage their own condition, and
(4) reconciliation of medications at discharge or immediately afterward (Kripalani et al. 2007). While many of the most promising interventions for lowering readmission rates address some or all of these factors, relatively few have been rigorously evaluated (Minott 2008).
This study adds to a body of other literature about medication adherence. A separate study in the American Journal of Cardiology shows that patient medication adherence cuts hospitalizations by 9 percent and reduces costs by as much as $944 in cholesterol patients.
This New York study may well be applicable to Canada, as they discuss a financial reward for reducing readmissions. While follow-up phone calls were shown as effective as more expensive interventions, e.g., nurse advocate to assist the patient upon discharge, the lack of communication, and the phone calls by medical staff, cannot be charged, I would imagine, and may not be seen to be worthy of staff time.
It would seem to me that follow-up care and prevention would be a normal part of physician care. This is hard to explain, how many times patients return to a hospital setting.
For more information:
- check out the report (.pdf)
Typically, 20 to 25 percent of patients age 65 and older are readmitted after 30 days, according to a (Canadian) press release. However, with intervention, a visiting coach can help cut the rate of readmissions.