Hospital Readmission and Home Care

 

 

Around 20% of hospital admissions are actually patients readmitted within 30 days. This boomerang effect adds a tremendous cost to the cost of health care.  According to The Agency for Healthcare Research and Quality (AHRQ), 90 percent of readmissions are unplanned.  The study claims that the high percentage of readmits is mostly due the prro care coordination often related to problems with medication management.   Until recently, hospitals had no real incentive to prevent readmits. In October 2012, Medicare and Medicaid services began to penalize facilities in order to reduce this problem.  The solution is to focus on the discharge planning process.  The research shows that medication mismanagement is the main reason elderly patients are being forced to return to the hospital within 30 days.  An attempt is being made to have collaboration between the hospital and the pharmacy or between the hospital and the primary care doctor.  An attempt needs to be made to tie all the parties together.  On discharge the patient needs to be educated about their medications. The pharmacy and primary care doctor as well as the discharge planners working together is important to help stem the flow of hospital readmissions.

At the time of discharge priority should be given to patient education – primarily medication education and instruction. This education plus a telephone follow up and a visit to a physician soon after.  According to recent studies, the majority of patients are failing to take their medications properly.  This is especially true for patients with multiple ailments. Another reason for a re-admit is that the patients fail to see a physician or other health care provider in a timely manner after leaving the hospital.  Studies have shown that physician follow up can reduce readmissions. To prevent readmissions the hospital  will have to take a more active role in staying in contact with after discharge. This can be done with frequent phone calls to make sure the patient is taking the correct medications and keeping doctors appointments. 

Home care is a key way for hospitals to reduce readmissions. Having home health aide services upon discharge can help reduce readmissions dramatically. Beside providing personal care assistance, the aide can assist with medication reminders and transportation to appointments. The aide is also important in providing a objective 3rd party in assessing changes in the patients health.  Having an aide with the patient allows the patient to remain safely in the comfort of their own home and offers hospitals protection from readmission penalties.  In the great majority of cases the patients much prefer to remain in their own homes rather than be readmitted to the hospital. 

    


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