Studies Find Post-Discharge Care Could Cut Hospital Readmissions
20May2014
For some hospitals, care of patients and accountability for their well-being seems to end when the patients are discharged. But a recent report highlights post-discharge complications and argues that hospitals need to be concerned about how patients are faring for at least 30 days after discharge.
Complications that emerge after discharge increase the chances that a patient will have to be readmitted to the hospital. According to the study published in JAMA Surgery, patients who suffer complications after discharge are more likely to be readmitted than those who suffer complications while they are in the hospital.
The study was based on an analysis of approximately 60,000 patients who underwent surgeries at Veterans Affairs hospitals. Approximately 23 percent of the cases involved complications before or after discharge. Overall, about 12 percent of the patients were readmitted within 30 days after their operations.
More than a quarter of complications tracked in the study occurred after the patients had been discharged. Many of the post-discharge complications were surgical-site infections.
In separate research, the Mayo Clinic has said that hospitals can reduce readmissions by taking multifaceted steps, including interventions to help patients deal with self-care tasks. The researchers pointed out readmissions have a big impact on patients’ lives and on medical costs.
According to the Mayo Clinic, approximately 1 in 5 Medicare patients has to be readmitted to the hospital within 30 days after discharge. Such readmissions cost the health-care system more than $26 billion annually.
“Patients are sent home from hospitals because we have addressed their acute issues,” Dr. Aaron Leppin, M.D., said in a Mayo Clinic news item. Dr. Leppin is a research associate in the Mayo Clinic’s Knowledge and Evaluation Research Unit.
“They go home with a list of tasks that include what they were doing prior to the hospitalization and new self-care tasks prescribed on discharge. Some patients cannot handle all these requests, and it is not uncommon for them to be readmitted soon after they get home. Sometimes these readmissions can be prevented,” Dr. Leppin said.
It is evident that procedures and policies for reducing readmissions must take into consideration post-discharge care of the patient. The Mayo Clinic’s report outlined a number of strategies to reduce readmissions by delivering care to patients after discharge.
One such strategy included visits by hospital staff to patients’ homes after discharge. This helps staff members understand the patients’ home environment and the support they need to care for themselves after they leave the hospital. Home visits can help staff determine what resources are available to patients and recognize the patients’ physical and psychological limitations.
Mayo Clinic researchers believe such approaches can work effectively, in contrast to more high-tech approaches that may be more expensive and not as effective in the long run.
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