Consider cultural sensitivity, diet tips to cut readmissions

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Hospitals are under pressure from Medicare--the federal purse holder--to curb readmissions. Although many providers have argued that patients' social factors, including race, geography and income, greatly affect readmissions outside of their control, some hospitals are taking the initiative to consider patients' culture in the discharge management process.

For instance, Shady Grove Adventist Hospital in Rockville, Md., offers culturally specific diet tips when doling out advice about patient health, encouraging Salvadoran patients to roast meat instead of frying it, Kaiser Health News and The New York Times reported. The hospital also suggests to patients to use sugar substitutes when making the common Central American drink, horchata, the news outlets noted.

New Jersey's Hackensack University Medical Center, similarly, instructs caregivers about diet. One place "didn't even know what a low-salt diet was," even though that's a critical part of keeping heart failure patients from retaining fluids, Charles Riccobono, chief quality and safety officer at the New Jersey hospital, said.

Such interventions are a result of Medicare reimbursement penalties of up to 1 percent for heart failure, heart attack and pneumonia readmissions. Although some providers have advocated for care management and rapid-response discharge teams for years, the financial penalties require that hospitals now pay more attention since the changes went into effect last month.

More than 75 million people in the United States suffer from two or more chronic conditions, but a study published in a journal from the American Heart Association this summer revealed that very few patients succeed in managing all of their conditions at the same time. Even patients who kept on top of their nutrition, physical activity, medication and self-monitoring requirements had trouble maintaining "simultaneous control" over their conditions in the long term, the association found.

Post-discharge intervention, particularly around culturally specific diet considerations and nutritional education, could help patients manage their health after they leave the hospital.

For more information:
- read the New York Times/Kaiser Health News article

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