DISCHARGE TOO SOON
Our local paper is writing less articles themselves, and printing more AP articles. Bad news is we read very little about local issues, good news is we are more plugged in to national issues.
Like this one – 1 in 5 Medicare patients rehospitalized in a month; study says patients get too little advice
Associated Press Writer Stephanie Nano writes “that one in five Medicare patients end up back in the hospital within a month of discharge, a large study found, and that practice costs billions of dollars a year. The findings suggest patients aren’t told enough about how to take care of themselves and stay healthy before they go home, the researchers said. A few simple things – like making a doctor’s appointment for departing patients – can help, they said.
The study found that a surprising half of the non-surgery patients who returned within a month hadn’t even seen a doctor between hospital stays.
“Hospitals put more effort into the admission process than they do into the discharge process,” said Dr. Eric Coleman, one of the study’s authors from the University of Colorado in Denver.
Coleman, who runs a program to improve “hand-offs” between health care systems, said patients often have a honeymoon notion about how things will be once they’re home. Then when they become confused about how to take their medicine or run into other problems, they head back to the hospital because they don’t know where to turn, he said.
The issue of hospital readmissions and their cost has come under scrutiny in recent years. And it’s getting attention now because President Barack Obama’s budget calls for reducing spending on Medicare readmissions to pay for health care reform.
For their study, reported in Thursday’s New England Journal of Medicine, the researchers looked at Medicare records from late 2003 through 2004. They found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge; about a third were back in the hospital within three months.
About half of the patients hospitalized for ailments didn’t see a doctor before they landed back in the hospital within a month.
Patients with heart failure and pneumonia had the most readmissions overall; among surgical procedures, heart stents and major hip and knee surgery had the highest returns.
About 10 percent of all readmissions were probably planned, such as putting in a stent, the researchers said. They estimated that the cost of unplanned return visits in 2004 was $17.4 billion.”
The article calls attention to a major concern. I have had very ill (cancer) family members who have tried to get two treating physicians to talk to one another about the family member’s care. When this person asked the doctors to engage in a quick call, one refused.
WHY? My guess is he couldn’t bill her for the call – only a visit.
What if doctors could charge Insurance / Medicare etc – for a call? Would this help alleviate some of the return issues?
Apparently, the study agrees with my phone call idea:
“Besides making follow-up doctor appointments, Jencks said hospitals should give patients a list of all their medications, explain what to do at home and where to call if they run into problems. He said the hospitals should also call the patient within two days and make sure that the patient’s doctor knows they were in the hospital.
He said the goal is to keep patients from getting really sick again, not to keep them out of the hospital if they do.”
AMEN. And in the meanwhile, lets try to figure out how we can put care above billing. Maybe allow for docs to bill for advice that is not only hands on care.