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Medicaid Status, Race Linked with Hospital Readmissions

HealthLeaders Media Staff, October 15, 2010

"Given the breadth of risk factors we identified, it seems likely that more intensive interventions will require a multidisciplinary approach, one which might be costly if applied broadly. Our study does not attempt to predict who will be readmitted and who will not, but rather provides a list of risk factors which might be used to deploy resources more efficiently."

"The US spends over $15 billion in Medicare on readmissions to hospital within 30 days and readmissions are also distressing to patients and their caregivers," Allaudeen, now based at the VA Palo Alto Health Care System, California, said in a statement. "Many healthcare systems are now making efforts to improve the transition from hospital to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact. Studies like ours should give practitioners direction to non-clinical factors to identify."

She and her colleagues note that further, in-depth research is needed—research that incorporates the patient experience. "Both black race and Medicaid as payer are proxies for the underlying root cause aspects leading to readmission, such as access to longitudinal care. Following this trail to the ‘root cause’ will require in-depth qualitative evaluation that includes the patient perspective as a source of data," they write.

The authors place this task with the hospitalist. "Hospitalists, who are at nexus of the discharge process and uniquely invested in quality inpatient care, are ideally positioned to lead efforts to reduce readmissions."

See Also:
Depression May Contribute to Hospital Readmission Risk
Follow-up Appointments May Not Reduce Readmissions
4 Ways Hospitals Can Avoid Readmissions

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2 comments on "Medicaid Status, Race Linked with Hospital Readmissions"


Steve Daviss MD (10/16/2010 at 2:26 PM)
Maryland is considering a potentially preventable readmission program via financial disincentives through its hospital regulated rates program (HSCRC). It identifies ANY psych or substance abuse readmission as being potentially preventable, meaning the index admission is potentially not paid for. The mental health community is concerned about unintentional consequences of this policy, planned to go into effect 2010. http://www.hscrc.state.md.us/init_qi_MHPR.cfm

Susan Ward (10/15/2010 at 9:54 AM)
One of the factors in hospital readmissions that none of the studies seem to take into consideration is "patient noncompliance". You can provide all the teaching and interventions you can think of, but if the patient is noncompliant after leaving the hospital, they are more likely to be readmitted. One intervention that the federal government does not like is "home care". Home care following a hospital admission will asssit the patient in compliance with the treatment plan developed on discharge from the hospital. However, the federal government does not see this important role that home care plays after hospital discharge.