Readmissions Nowhere Near Remission

Despite an ongoing push to reduce hospital readmissions among Medicare patients, a new study by the Robert Wood Johnson Foundation concludes that one in eight require more acute care within 30 days, with rates significantly higher in several major Midwest cities.

According to the report, which is entitled “The Revolving Door” by researchers, 12.4% of Medicare patients nationwide wind up back in the hospital within 30 days of their original discharge. The study was based on 2010 data, and was virtually unchanged when compared to the numbers compiled in 2008, researchers said.

Hospital readmissions cost up to $26 billion a year, according to the Robert Wood Johnson Foundation, and at least $17 billion in these expenses are avoidable if patients receive proper care.

The readmission rates were higher than the national average within several populous Midwest states. Illinois, for example, had a readmission rate of patients being treated for an illness of 16.8% – compared to the national average of 15.9%. Among those who underwent a surgical procedure, the readmission rate was 13.6%, compared to the 12.4% national rate. Ohio and Michigan also had rates above the national average for both cohorts, although their numbers were better than those in Illinois.

The rates were significantly higher in Chicago, the most populous city in the Midwest, and Detroit, which has some of the worst health indicators in the region, researchers said.

Minnesota performed significantly better than the national averages, with a rate of illness-related readmissions reaching 15.2%, and just 10.7% for surgical cases. Wisconsin also posted numbers that were below the national averages.

“While there are certainly pockets of improvement, as a nation, we have a long ways to go,” said David C. Goodman, M.D., the co-principal investigator for the Dartmouth Atlas, which compiled the information on the foundation's behalf. “Variation in the quality of care between health systems is hard for patients and practicing physicians to see, but the differences are substantial. And many patients are readmitted simply because they live in a region where the hospital is used more frequently at the site of care.”

In additional to general illness and surgical cases, the survey also measured discharge rates for chronic and often difficult to control conditions such as congestive heart failure and pneumonia.

Foundation researchers concluded that ensuring patients have the proper prescription medication upon discharge and seeing a primary care physician or an ambulatory care visit within 14 days of discharge can reduce readmissions.