Understanding is Key to Staying Out of the Hospital - Part I

A recent study by the Northwestern University Feinberg School of Medicine examined the frequency of rehospitalization, the risk of readmission and the frequency of follow-up outpatient doctor visits before being discharged from the hospital. The study looked at fee-for-claims service data for roughly 12 million Medicare patients discharged from a hospital in the years 2003 and 2004.

What the study found was astounding.

One out of five Medicare patients is readmitted to the hospital. The healthcare tab for readmissions in 2004 was 17 billion dollars. More than half of the patients that are rehospitalized within 30 days did not see a physician as an outpatient after being released the first time.

The study found that the rate of readmission increases as time passes from the first hospitalization. Thirty-four percent of patients were readmitted within 90 days of release and that number increases to 56.1 percent after one year of release.

Of those readmitted, 70 percent suffered from complications that could easily have been prevented by follow-up doctor visits such as urinary tract infections or pneumonia.

The study co-author, Mark Williams, M.D., chief of hospital medicine for Northwestern’s Feinberg School of Medicine and Northwestern Memorial Hospital, commented that Medicare does not pay doctors or pharmacists to spend time with patients to make sure they understand their discharge and medication instructions when they leave the hospital. “They pay for quantity of service, not quality.” He further adds, “They [Medicare] do not target payments to improve patient understanding of their care and their need for follow-up.”

“When patients and their caregivers understand the goals of their care, they commonly get better relief from their symptoms and use less health care services at their request,” Williams said.

Creating understanding for all patients regardless of their age or language spoken is the key to reducing our country’s healthcare costs by keeping needless hospital readmissions to a minimum.

Check back on Wednesday for Part II and read about another study linking understanding with improved healthcare.

by Sherry Dineen

The study was published in the New England Journal of Medicine on April 2, 2009 and can be found using the following link:
http://content.nejm.org/cgi/content/full/360/14/1418

Mr. Williams’ comments can be found at: http://www.northwestern.edu/newscenter/stories/2009/04/medicare.html