Struggling To Reduce Hospital Readmissions

As hospitals and administrators here in Massachusetts bicker over whether providers should face financial penalties for higher-than-average readmission rates, facilities across the nation are struggling to keep patients from returning to the hospital again and again.

The Wall Street Journal health blog reports on findings out this week from The Dartmouth Atlas Project showing readmission rates for Medicare patients haven’t improved much in recent years. Katherine Hobson reports:

If you’re a Medicare patient admitted to the hospital, the odds are about one in six that you’ll end up back in the hospital within a month. And there was very little progress made in reducing that rate between 2004-09.

That’s the not-so-good news from a new report by the folks at the Dartmouth Atlas Project, which tracks variations in medical care across the U.S. The report also found that more than half of Medicare patients who left the hospital didn’t see a primary-care doctor within two weeks of discharge — identified as a contributing factor to the revolving-door problem.

But Hobson also highlights one Chicago Hospital, Northwestern Memorial, that has reduced its readmissions rates through a combination of fairly low-tech interventions: more control of the patient discharge and handoff to an outside doctor and followup calls to check on prescriptions and schedule appointments with a primary care doctor, for instance.

Northwestern Memorial has also developed an algorithm to pinpoint certain heart-failure and heart-attack patients at the highest risk of readmission and to target efforts at them.

It’s also partnering with a local pharmacy chain to develop a way to help patients who can’t afford their medications to get them, and has considered setting up an on-site clinic to make sure patients get follow-up care in a timely manner, says Noskin.

He says the hospital has made “significant progress” and will keep trying to get readmission rates as low as possible — while acknowledging that not all readmissions are preventable.

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