Readmission conditions

The ethereal world of Medicare cost savings | Matt Anderson

Illustration by Krieg Barrie

The New England Journal of Medicine in April published a paper by Drs. Jencks, Williams, and Coleman pointing out the costly problem of re-hospitalization of Medicare patients: $17.4 billion of the $102.6 billion that Medicare spends annually on hospital care comes from hospital readmissions. The authors conclude that too many patients on Medicare are readmitted, about 20 percent in the first 30 days, and 34 percent in the first 90 days after discharge. About 67 percent of Medicare patients who were discharged with a medical diagnosis (diabetes, chronic lung disease, heart failure, etc.) were either readmitted or died the year after discharge.

The authors go on to speculate on the ways to decrease hospital readmissions, including (1) better care for conditions such as heart failure, including more support for out-patient home care; (2) more outpatient visits to doctors; (3) earlier doctor visits after surgery; (4) a concern about hospital profit motives; and (5) decreasing state-by-state variation in readmission rates.