American Discharge
Heart attack patients from the United States were 68 percent more likely to be readmitted within one month of their discharge than patients in 16 other countries. More evidence that we have a bad healthcare system, right? Not exactly. The study in JAMA also showed that U.S.-based patients were more likely to have shorter hospital stays. What does this mean? Our goal (which is really the insurance company’s goal) of hurrying up and discharging heart attack patients as early as possible is correlated with a higher chance of them coming back again. Talk about common sense. Doctors and patients are damned if they do and damned if they don’t, here. They have intense pressure from the insurance companies to get the patient out of the hospital as quickly as possible (or they won’t pay for those extra days) but then are penalized for a higher readmission rate if they come back (bogus quality score stuff). Though this is kind of an obvious study it is a good one because it indirectly shows the insanity of our healthcare system that has too many outside interests determining the care of a patient. How about this? How about letting the symptoms, progress, health and situation of the individual patient determine the care of the patient and screw the quality scores and insurance companies?
I believe the trick is to encourage patients to go to the other health system across town for the “readmission”. If both systems will cooperate on this, quality scores for both systems will suck equally forcing the insurance companies to lower their high expectations.
You get a big ‘Hell, yeah!’ from this country gal! And as you well know its not just cardiac patients….it’s all across the board. Common sense and tort reform are two missing pieces in healthcare today. More of each might help patient care improve…maybe??
Was there any way to be certain that the cause of the increased readmission could be attributed to the shortened stay? I have little doubt that it contributed, perhaps greatly, but the cause/affect assumption would be stronger if the effect of short hospital stays was clearly related.
If the money taken by insurance companies from the imposition of risky quick discharges could be applied to a better and organized followup system that didn’t confer the sole responsibility for continuity on already overburdened docs and hospitals it could too reduce readmissions.