Readmissions

Hospital readmissions are a huge problem because many of them can be prevented.   This is why the government and insurance companies are squeezing hospitals and holding their feet to the fire by penalizing them if those readmissions do occur.   Call it a carrot or a stick but the result is the same.  “Readmission rate” is the poster child for the quality movement.  The problem is that many of those readmissions also cannot be prevented.  A new study  found that one-third of adult patients discharged from a hospital do not see a physician within 30 days of release, putting them at risk of readmission. About 8% of discharged adults were rehospitalized during that time, while 33% were readmitted within a year.  This is all explained in a recent American Medical News article.   The cause of this lack of follow-up is explained as a “systemic breakdown” with a need for a “system of providers” working together to solve it.   They recommend greater hospital/physician collaboration and better tracking technology.   Lastly, they state this is an area of opportunity for primary care doctors to step up to the plate.    You know what?  I agree with all of this.  I really do.  In a perfect world there needs to be good follow-up, perfect handoffs, seamless technological record release and so on.  Let’s make it happen.  Oh, but there is one other thing.  As mentioned in a recent blog where I showed you that half of post-MI patients stop taking their medications within a year even though it was given to them for free, I think somewhere in the article it should be mentioned that personal responsibility is pretty important as well.  Doesn’t that sound reasonable?   Amazingly enough, doctors are NOT the cause for all things going wrong in the healthcare system.  Maybe, just maybe, we can mention that having some healthy habits like eating right, keeping a proper weight, exercising, sleeping well, not smoking or doing drugs, taking your medications and following up the doctor is actually part of that personal responsibility.  And penalizing doctors for those things NOT happening is, well, asinine.

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