High-readmission hospitals use follow-up to keep patients from returning

Like other hospitals across the country, Barnes-Jewish Hospital in St. Louis suffers from high readmission rates. Twenty-eight percent of its heart failure patients on Medicare return to the hospital, compared to the national average of 24.8 percent, according to a St. Louis Post-Dispatch article yesterday.

But with its new Stay Healthy Clinic that opened a month ago, Barnes-Jewish Hospital is aiming to cut down on returning patients. A physician at the clinic sees high-risk patients within a week after hospital discharge. The risk is determined by patients' clinical diagnosis, as well as their social situations. The hospital also arranges for transportation for the clinic visit, if needed. Through these 20-minute follow-up visits, the physician talks to patients about their discharge instructions and answers any questions they might have.

Thus far, half of the patients recommended for clinic follow-up show up to their appointments, according to the article.

Similarly, hospitals in the Tampa Bay, Fl., region--an area that serves poor patients and has high readmission rates--are using follow-up care to curb the readmission rates.

Research shows that following up within 14 days of hospital discharge can help them from readmitting, according to a Tampa Tribune article today. But many smaller hospitals may find it more difficult than larger institutions to find the staff to make follow-up calls or visits. Small hospitals do have an advantage, though, in personal connection.

"We see these people in the grocery store," said Marge Keck, the chief nursing officer at Pasco Regional Medical Center in Florida. "So we really interact with our patients after discharge."

Despite national efforts to keep patients from returning to the hospital, readmission rates have been relatively stagnant, according to what many saw as a disappointing report by the Dartmouth Atlas Project last month. The report found that about one in six Medicare patients ended up back in the hospital within 30 days of being discharged. National readmission rates for medical conditions slightly rose from 15.9 percent to 16.1 percent, and readmission rates following surgery stayed at 12.7 percent.

Starting in fiscal year 2013, hospitals with high readmission rates will face a 1 percent penalty. In 2014, hospitals will face a 2 percent penalty and, in 2015, a 3 percent penalty.

For more information:
- read the St. Louis Post-Dispatch article
- read the Tampa Tribune article

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