Often times patients have to revisit the hospital after being discharged as part of scheduled care, but sometimes readmissions are caused by a failure of the system.
The Pennsylvania Health Care Cost Containment Council – or PHC4 – recently released a report looking at preventable readmission rates statewide for patients with four conditions that often lead to hospitalization.
The council found that readmissions for chronic obstructive pulmonary disease and congestive heart failure have been reduced by 26 percent in recent years, while there have been no changes in readmission for abnormal heartbeat and diabetes.
Dr. Michael Consuelos, senior vice president of clinical integration for the Hospital and Healthsystem Association of Pennsylvania, said the decline in preventable readmissions for two of the conditions can be attributed to hospitals identifying groups of people who use the system more than others.
“So they focus in on those patients and try to look at not just medical care but also social supports, their integration into the community, a lot of times there are behavioral health issues in this population. So it’s sort of wrap-around services around these patients who have a tendency to be admitted many times more than their peers,” he said.
The report shows that for many patients, readmission within 30 days is often for an unrelated condition than what originally caused hospitalization. Consuelos said this is often because those patients are very sick to begin with, but the fact that those patients aren’t coming back for the same reason is a good sign.
He said better communication with the patient leads to better outcomes.
“So that may be better instructions, improving their health literacy, but also a better communication between the providers of care between the physicians and nursing staff within the hospital stay but also as they leave the hospital going back to their primary care provider or nursing home,” he said.
Not only does a reduction in unnecessary readmissions cut costs for the hospital, it saves emotional and economic burdens for patients. A large proportion of patients who were readmitted are Medicaid patients or as Consuelos points out, the working poor population.
“So many of them are hourly wage earners so you can imagine if they were in the hospital for another two or three days or have to go back to the hospital, they aren’t earning wages, they aren’t providing income to their families,” he said.
PHC4’s report shows that about $150 million in health care dollars are used for readmissions. While not all of those readmissions are to blame on the hospital, Consuelos said the health care system still has a lot of work to do.
