On Oct 1st, Medicare will begin cutting payments to hospitals where too many patients are readmitted within 30 days of being discharged. The Medicare Payment Advisory Commission (MedPAC) reported that in 2005, 17.6% of hospital admissions resulted in readmissions within 30 days of discharge.
Too many people are returning to the hospital.
These transfers can increase the risks to the patient including delirium, medication errors, falls, and infection. Medicare, Medicaid, and private insurance pay out hundreds of millions of dollars each year in the process. The majority of these re-hospitalizations are preventable according to most studies. Health care professionals believe that the high readmission rates for patients are due to two main factors: inadequate relay of information by hospital discharge planners to the patient and poor patient compliance with care instructions. With these changes in Medicare, hospitals should be taking steps to address this problem. This will require a change in the mindset of hospital administrators.
In order to accomplish this change, the hospitals need to improve the discharge process and keep a closer eye on the patients after they leave. For those patients that are discharged back to a nursing facility, the hospital will have easier time. The facility has trained staff that help ensure that the patient complies with the care instructions and avoid returning to the hospital.
For those patients returning to their homes and not having any help from family or friends, the hospitals should suggest that the patient involve an outside agency such as Thrive at Home to help with care. This can help ensure that the patient is able to follow the instructions given by the discharge staff at the hospital and begin the process of the return the healthfulness. The agency will provide a caregiver that will help with carrying out the hospital instructions as well as help with the activities of daily living. For the most part this service is paid by the patient or the patients’ family. This is no easy task for the discharge planners at the hospital since the hospital doesn’t know the financial status of the patient. As this rule takes affect, the hospitals will find that they have patients that need private duty services. Some can afford the services and some of them can’t. It should become policy that the discharge planners give the patient or the families a list of the agencies in the area that provide private duty services. The family can contact the agency directly and discuss whether the service might be valuable for the family and whether it is something they would be willing to pay for.