Hospital Readmission Rates on the Rise in Older Adults:
TUESDAY, Oct. 4 (HealthDay News) -- Readmission rates have
increased in many hospitals across the United States, including
some of the country's most elite academic medical centers, new
research shows. About one in six Medicare patients now returns to
the hospital within 30 days of being discharged for a medical
This news comes as hospitals brace for penalties -- reduced
payments for readmissions -- for excessive readmission rates among
Medicare patients that take effect in 2013, according to a news
release from the Dartmouth Atlas Project, the source of the new
In conducting the study, researchers analyzed hospital discharge
records of nearly 11 million Medicare patients. They found big
discrepancies in 30-day readmission rates across U.S. regions and
academic medical centers and a lack of follow-up care for
discharged patients. And, they found, more than half of Medicare
patients do not see a primary care clinician within two weeks of
leaving the hospital.
"The report highlights widespread and systematic failures in coordinating care for patients after they leave the hospital," study lead author, Dr. David C. Goodman, director of the Center for Health Policy Research at the Dartmouth Institute for Health Policy and Clinical Practice, said in the news release. "Irrespective of the cause, unnecessary hospital readmissions lead to more tests and treatments, more time away from home and family, and higher health care costs."
Although 30-day readmission rates remained largely unchanged in
the United States between 2004 and 2009, readmissions decreased in
11 regions. Leading the pack: Bismarck, N.D., where readmissions
for medical conditions dropped to 14 percent in 2009, from more
than 16 percent in 2004.
In contrast, readmissions for medical conditions rose in 27
regions across the country. The worst offender was Aurora, Ill.,
where readmissions jumped to 18 percent in 2009 from a little over
14 percent in 2004.
More people were readmitted to the hospital following surgery in
18 regions, most notably White Plains, N.Y., with a jump from 13
percent in 2004 to more than 17 percent five years later.
Meanwhile, 28 areas saw a drop in surgical patient readmissions,
including Elyria, Ohio, which fell from 19 percent in 2004 to
slightly over 15 percent in 2009.
Seven academic medical centers had significant changes in 30-day
readmission rates following medical discharge and surgery from 2004
to 2009. Although Chicago's Northwestern Memorial Hospital showed
the largest drop in readmissions for medical conditions, the
University of Connecticut Health Center, in Farmington, jumped from
about 13 percent to almost 18 percent.
Meanwhile, surgical readmissions at the University of Missouri
Hospital and Clinic in Columbia, Mo., decreased from almost 20
percent in 2004 to less than 15 percent in 2009. In contrast,
Montefiore Medical Center, in New York City, increased from nearly
16 percent to more than 19 percent.
Researchers noted a lack of follow-up care after patients were
discharged. Overall, about 43 percent of patients discharged from
the hospital in 2009 following a medical treatment had a primary
care visit within two weeks. The discrepancies were even more
pronounced among academic medical centers. For instance, less than
20 percent of patients discharged from New York University Medical
Center followed up with a primary care physician within two weeks
of being discharged. That rate was nearly three times higher,
however, at the Mayo Clinic's St. Mary's Hospital in Rochester,
Lack of follow-up care and high readmission rates are
preventable, the authors said in the release.
"It's very important that patients and health care providers communicate clearly so that all questions are answered and everyone understands what will happen when the patient leaves the hospital," Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, a longtime project funder, said in the news release.
"Everyone -- patients, doctors, nurses, caregivers -- has a role to play in ensuring quality care and avoiding another hospital stay. They need to work together to create a plan for how care will proceed when the patient returns home. This should include a clear understanding of the patient's medical problems, a schedule for follow-up appointments, a list of medications and instructions for taking them," she added.
The Family Caregiver Alliance has more about
hospital discharge planning.
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