Medicare patients readmitted to hospitals cost an estimated $17.4 billion in 2004, several years before a legion of aging baby boomers will become eligible for the entitlement. Better planning for patient care post hospitalization, including the broad establishment of patient-centered care otherwise known as medical homes, could have prevented many unnecessary and costly readmissions, according to a new study in today's New England Journal of Medicine.
The Commonwealth Fund-supported study, "Re-hospitalizations Among Patients in Medicare Fee-for-Service Program," found that the highest rates of readmitted Medicare patients in five states: Maryland, New Jersey, Louisiana, Illinois and Mississippi. Their readmission rates were 45 percentage higher than the states with the fewest cases: Idaho, Utah, Oregon, Colorado and New Mexico.
About 50 percent of patients returning to the hospital had not had any outpatient follow up visits with a clinician after their first hospitalization.
"Payment reform that provides the right incentives for patient-centered care is a win for everyone., said Commonwealth Fund vice president Anne-Marie Audet, MD. "We can improve patients' lives and health, save our health care system billions of dollars, and strengthen the primary care system."
Researchers found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge; about a third were back in the hospital within three months. Patients with heart failure and pneumonia had the most readmissions overall. Surgical patients who had had heart stent procedures and major hip and knee surgeries had the highest returns.
- see The New England Journal of Medicine story