Hospital Re-admission — do phone calls help?

Jphoneust calling a patient on the phone does not prevent patients from being re-admitted!

Hospitals are very interested in preventing a patient from returning to the hospital (called a re-admission) within 30 days from discharge due to the financial penalties from Medicare.

For example, if a patient is hospitalized with a serious problem called congestive heart failure (fluid retention that causes shortness of breath) the hospital will be penalized financially if the patient gets the condition all over again and has to return.

The government idea is to force hospitals to be more accountable — it’s like a 30 day guarantee from an auto repair shop!  So hospitals are looking for ways to improve their performance (and avoid paying money).

There is no question frequent visits to a physician can reduce re-hospitalizations.  However, a recent hospital study found that hospital nurses who talked to patients before discharge and who called them after discharge did not help the readmission problem — in fact there were more re-admissions!

a)  How can this be?

b) Do well meaning nurses actually make the problem worse?

c) Does this mean hospitals should not be penalized?

The answers are: a) bad science b) yes  and c) no, perhaps they should be penalized more!

The “bad science” part is because there was no intervention to adjust medications or treatments that might prevent readmission.   A hospital nurse only has one option for a telephone  intervention:  “you better get checked at the ER”.  The conclusion from the study should have been stated “chatting with a patient does not prevent re-admission” — brilliant deduction.

The outpatient care provider’s  office is where action can be taken to stop re-admissions.  That’s where medications can be prescribed.  If the hospital wanted to prevent re-admissions they should have made an appointment and given the patient a coupon for a taxi ride to and from the outpatient office.   This is not rocket science.

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