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High Readmission Rates Found in Medicare Population

Posted Apr 23 2009 5:25pm

Medicare patients discharged from a hospital are frequently readmitted within a few months, suggesting that post-acute care is suboptimal, researchers said.

Some 20% of all Medicare recipients hospitalized in one 15-month period were readmitted within 30 days of discharge, and 34% were readmitted within 90 days, reported Stephen F. Jencks, M.D., M.P.H., a private medical consultant in Baltimore, and colleagues in the April 2 issue of the New England Journal of Medicine.





Two-thirds of those hospitalized with medical conditions, as well as 51.5% of patients undergoing surgery, were rehospitalized or died within a year of discharge, the researchers also found.

“We estimate that about 10% of rehospitalizations were likely to have been planned,” Dr Jencks and colleagues said.

They suggested that much of the remaining 90% experienced some kind of breakdown in postdischarge care.

In an interview, Dr. Jencks said a key finding was that half all patients rehospitalized within 30 days had no record of outpatient care following the initial discharge.

As late as three months after discharge, some 20% still had not been seen by a physician.

“It’s pretty clear that simply giving patients a phone number to call for a follow-up appointment is not enough,” he said.

The researchers analyzed data on some 11.9 million fee-for-service beneficiaries whose Medicare records showed a hospital discharge in 2003 and 2004.

Overall, the most common reasons for rehospitalization among medical patients were heart failure (8.6%), pneumonia (7.3%), psychoses (4.3%), and COPD (3.9%).

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