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Hospital Readmissions and Medicare

Posted Nov 28 2012 12:40pm

I was delighted to see the article in the New York Times  (11/27/12) by Jorday Rau discussing hospital readmissions.  In the last few years, hospitals have been sending patients home as quickly as possible with often little follow-up care. In my book, 101 Ways To The Best Medical Care, I give an account of an eighty-year-old woman who was hospitalized for heart failure.  After a few days, she recovered enough to be sent home. However, her physician obviously made no effort to find out that she had lived alone, had no family support, and  few friends she could call on to help. The woman tried to cope with her day-to-day care, but after two days, a neighbor found her on the kitchen floor in great pain. She had fallen and broken her hip. An extensive and expensive hospitalization was necessary which Medicare had to pay. There should have been a follow-up visit by a visiting nurse, at the minimun, or home health aides provided for a few days. The doctor could simply had had his secretary fax a prescription to the local home health agency and aides would have been provided for everything from nursing care, to cooking or grocery shoping. if a P.T. or O.T or other type of professional was needed these could have been provided. These would all be paid by Medicare. I greatly fault the attending doctor or doctors  and unfortunately this situation occurs far too often.

Now Medicare has realized that something needs to be done about patients like this and they are going to start requiring financial penalties from hospitals that have a high percentage of readmissions after discharge.Initially, this will be just for heart attack, heart failure, and pneumonia cases. I hope this results in  better post-op care and makes doctors get to  know their patients, so they will  be sure there will be good care after discharge.

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