Lower readmissions tied to focus on whole patient, not symptoms and conditions

Reducing readmissions within 30 days may mean focusing on the whole patient, rather than just the person's symptoms and conditions that caused the original hospitalization, according to a new study published in the British Medical Journal.

Yale School of Medicine researchers found that top-performing hospitals with the lowest 30-day readmission rates had fewer readmissions for all diagnoses and time periods after discharge than lower performing hospitals with higher readmissions.

Researchers studied more than 4,000 hospitals in the U.S. caring for older patients hospitalized with serious heart problems or pneumonia from 2007 to 2009, examining more than 600,000 readmissions within 30 days.

"This study suggests that the path to excellence in readmission is a result of an approach that focuses on the patient as a whole rather than on what caused them to be admitted," said lead author Harlan Krumholz, M.D., the Harold H. Hines Jr. Professor of Medicine and professor of investigative medicine and of public health at Yale School of Medicine. "And this study adds emphasis to the idea that patients are susceptible to a wide range of conditions after a hospitalization--they are a highly vulnerable population and we need to focus intently on making the immediate post-discharge period safer."

Meanwhile, a heart failure collaborative made up of 11 hospitals in Michigan saw a 9.47 percent drop in readmissions, higher than the state average of a 4.86 percent reduction during that time period, according to an article in East Village Magazine.

The collaborative attributes its success to the "See You in 7" program which included:

  • developing a program for follow-up phone calls to patients after discharge;

  • providing a list of transportation resources for patients who have difficulty getting to their follow-up appointments; and

  • streamlining the process of identifying heart failure patients prior to leaving the hospital.

To further reduce readmission rates, hospitals should communicate with patients, follow up with patients after discharge, seek causes of readmissions and make the most of available technology, FierceHealthcare previously reported.

To learn more:
- here's the British Medical Journal study
- read the East Village Magazine article

Read more on