It's a return trip nobody wants to take: You are discharged from the hospital, only to find yourself readmitted a few days later.
More and more people are finding themselves in this revolving door — at a cost to both hospitals and patients. A 2009 study in the New England Journal of Medicine showed that 20 percent of Medicare patients discharged from the hospital had to be readmitted within 30 days, and 34 percent were back within 90 days. Those return trips cost the health care system more than $17 billion over one year.
Readmission rates have increasingly become a measure of a hospital's quality of care. As part of the Affordable Care Act, Medicare is planning to tie payment to readmission statistics, even penalizing hospitals for readmissions deemed avoidable.
With that punishment looming, hospitals and health policy experts are trying to figure out why so many patients are making round trips.
Hospitals cannot reduce readmission rates on their own. Success will depend on a coordinated approach involving primary-care doctors, pharmacists, an improved system of electronic health records and, perhaps most important, patients themselves. There are several simple but vital steps that patients should follow before and after leaving the hospital:
• Make sure you understand your diagnosis, and what was done to you.
• Know whom to follow up with (physical therapist, your regular doctor, a nurse, etc.).
• Schedule a followup appointment with your regular doctor before leaving the hospital; make sure to see him or her soon after discharge.
• Ask your hospital doctor to communicate with your regular doctor.
• Go over every medication on your discharge list with your doctor or nurse. Compare those drugs with medications you were taking before you entered the hospital to ensure there are no duplications or dangerous interactions.
• Get contact information for any questions or problems you might have after discharge.
• Ask what to expect during your recovery and what symptoms to look for should something go wrong.
• If some test results are pending, make sure you know how to obtain the results.
• Before you sign your discharge summary, make sure you understand everything. Ask someone — a nurse, a doctor, a social worker — to explain it to you.
• Bring a copy of your discharge summary to your followup appointment.
All of this increases the odds that, when you leave the hospital after surgery or illness, you won't be coming back again soon. The health care system will save money, and you'll be able to undertake your recovery, in your own bed, at home. And who wouldn't prefer that?