The Washington Post newspaper recently reported in-depth on the problem of “frequent fliers,” patients who leave the hospital, only to boomerang back
days or weeks later. The newspaper states that they have become a front-burner challenge not only
for hospitals and doctors but also for those trying to rein in rising
costs.
Typically elderly and suffering from the chronic diseases that
account for 75 percent of health-care spending, their experiences of
being readmitted time and again reflect many of the deficiencies in a
fragmented, poorly coordinated health system geared toward acute care, the Post reported.
There are many reasons for readmissions, including high rates of
medical errors and hospital-acquired infections; lack of communication
between doctors who care for patients in the hospital and their regular
physicians; trouble getting a prompt doctor’s appointment after
discharge; missed referrals for home health care; and poor coordination
and medication management during transitions from hospital to home or
nursing home.
“Transitions are just so dangerous. Every time you move a patient
from one setting or facility to another, you have to ask, ‘Is something
going to go wrong?’ ” said a geriatrician at Brown
University Medical School, who has often treated her patients in
nursing homes for conditions that otherwise would propel them back to
the hospital. Teno said the ways nursing homes are paid mean it’s often
easier for them to let the hospitals take care of sick patients.
Experts don’t agree on how many readmissions are avoidable. Dozens
of promising initiatives designed to cut down on them are underway. But
many experts say sweeping changes are needed in how health care is
delivered and how hospitals and doctors are paid — sensitive issues
that confront Congress and the medical industry in the debate on
overhauling the health system.
Readmission costs are staggering. One of five Medicare hospital
patients returns to the hospital within 30 days — at a cost to
Medicare of $12 billion to $15 billion a year — and by 90 days the
rate rises to one of three. Within a year, two out of three are back in the
hospital — or dead. For more, read the story.
________________________________________________________________
Robert W. Carter, Jr. is a Virginia attorney whose law practice is
dedicated to protecting the rights of the victims of nursing
home and assisted living neglect and abuse in Richmond, Roanoke,
Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
