By Laurie Robinson and Lisa Stansbury
Potentially avoidable hospital readmissions are a national health care problem affecting 17.6 % of all Medicare patients, and costing $12 billion annually, according to a 3M analysis of 2005 discharge claims data from the Centers for Medicare & Medicaid Services (CMS). The process by which patients move from hospitals to other care settings is increasingly problematic as hospitals shorten lengths of stay and as care becomes more fragmented. Medicare patients report greater dissatisfaction related to discharges than to any other aspect of care that Medicare measures.
In general, rehospitalization rates and health care utilization vary substantially across geographic locations, suggesting opportunities for improvement in areas with higher observed rates. The 2007 Commonwealth Fund State Scorecard Data Tables reported Louisiana as having the highest Medicare 30-day readmission rate in the country, (23.8% of all discharges of fee-for-service Medicare beneficiaries aged 65 and older in 2003, admissions due to 31 select conditions); the 2009 State Scorecard showed a slightly improved rate of 21.3%.3 Six months (10/08 through 3/09) of CMS data warehouse claims collected from the Baton Rouge, Louisiana hospital service delivery area of all Medicare beneficiary discharges also reflected a high 18.81% readmission rate.
CMS designed a project to test various methods for reducing avoidable hospital readmissions in 14 communities defined by hospital service areas across the country, including Baton Rouge, Louisiana. A primary objective of the Care Transitions Project is to reduce unnecessary all-cause hospital Medicare readmissions by 2% and the resultant exposure of the patient to risk and poor patient satisfaction with the health care delivery system. eQHealth Solutions was awarded the project and the work began in the Baton Rouge community on August 1, 2008. The project is scheduled to conclude on July 31, 2011.
Read the full article published in the July/August issue of the Remington Report.
1 comment
Luis
October 19, 2012 at 5:06 am (UTC 0) Link to this comment
Chris, this happens to be an area with which I have some eeerxipnce. Your points about technology and process are noted. Both seem to be catching up rapidly with the need. I think the biggest problem will continue to be finding professionals to do the work in the field. People in hospitals get around the clock nursing care. Most nurses would rather work in a hospital than drive around to different patients. Furthermore, having a dedicated nurse for one patient in their home is not cheaper than having a staff of nurses care for an even larger number of patients. When patients go home, many of them still need regular monitoring and light care throughout the day and night. The absence of this care is often what sends them back to the hospital.In a way, it’s like the prisoner who has been in the system so long, they can’t function on the streets. So, they get into trouble again, which causes them to be put back into the system, where they get the care they’d prefer. Breaking this cycle with technology will require some very fancy robots.