UK considers fining hospitals for readmissions

Looking to address a sharp rise in the number of emergency readmissions over the past decade--from 359,719 in 1998-99 to 546,354 in 2007-08--the government in the United Kingdom plans to begin charging hospitals financial penalties if patients are readmitted as an emergency within 30 days of being discharged, BBC News reports.

Under the new plans unveiled Tuesday by health secretary Andrew Lansley, hospitals would receive funding for the first hospital stay plus treatment for the patient's first 30 days after discharge, but would not be paid again for a patient brought back later with a related problem.

"Over the last 10 years emergency readmissions have increased by 50 percent. Not, it seems, primarily because patients were more frail," Lansley said, "but because hospitals have been incentivized to cut lengths of stay and send patients home sooner--process targets creating risks for patients."

"So in addition to getting rid of these targets, we're going to ensure that hospitals are responsible for patients not just during their treatment but also for the 30 days after they've been discharged," he added. "It will be in the interests of the hospital for patients to be discharged only when they are ready and safe."

On a morning news program, Lansley said the government was "very clear" that it would increase the National Health Service budget every year in real terms to meet the demands on the service.

Here in the United States, a recent Yale study examining hospitals' 'revolving doors' indicated that, at least for heart patients, short hospital stays may ultimately lead to higher health costs because of multiple unplanned readmissions.

In another study, the federal Agency for Healthcare Research and Quality reported that as many as one in four hospital patients are readmitted at least once within 30 days for the same condition, reports the Seattle Times. More than a third of patients suffering from obstructed arteries around the heart were readmitted at least once, while multiple returns also were noted for 30 percent of patients with uncomplicated diabetes, 28 percent with high blood pressure and 21 percent of those with asthma.

Researchers also found that 42 percent of all Medicare patients had multiple hospital admissions vs. 23 percent of Medicaid patients, 22 percent of the uninsured and 19 percent of people with private coverage.

To learn more:
- read this article on BBC News
- see this piece in the Wall Street Journal
- check out this story in the Seattle Times

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