Home From The Editor The changing face of readmissions

The changing face of readmissions

April 2013

Published in the April 13 issue of Today’s Hospitalist

THREE WEEKS AFTER BEING DISCHARGED from the hospital following a heart attack, an elderly man gets in a car accident and ends up back in the hospital. Should that visit be considered a readmission related to the care he received for his MI?

That may seem like an odd question, but in the current era of health care reform “which is focused largely on reining in runaway costs of health care “the definition of the term “readmission” may be changing in a way that will surprise many hospitalists.

In one feature in this issue, we talk to one of the policy experts leading the charge to re-think how vulnerable patients are at discharge and what should count as a readmission. He suggests that because discharged patients are at heightened risk of a whole host of cognitive and physical problems, the car accident could be related to the heart attack “or at least to the care the patient received while hospitalized.

Hospitals (and hospitalists) may need to do more, the thinking goes, to prepare patients for the post-discharge period. That could include urging them not to drive for a while and to avoid crowded places because they’re more susceptible to infections.

But the story makes a strong case that hospitals really need to do a much better job providing patients with a healthier hospital stay that isn’t rife with immobility, delirium, and sleep and nutritional deprivation. Researchers have even given a name to the kind of cognitive and physical fragility that patients may suffer after being hospitalized: post-hospital syndrome.

That syndrome may be the root cause of many readmissions, a radical re-imagining of what shape patients leave the hospital in and what brings them back. If new studies bear that hunch out, it could have a major impact on how hospitals and hospitalists approach patient care.

edoyleEdward Doyle
Editor & Publisher