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Readmissions May be Triggered by 'Post-Hospital Syndrome'
Take sleep deprivation stemming from a patient being in a noisy, unfamiliar surrounding, he suggested.
"This disruption can have debilitating behavioral and physiological effects: sleep deprivation adversely affects metabolism, cognitive performance, physical functioning and coordination, immune function, coagulation cascade, and cardiac risk," Krumholz wrote.
And then there is the issue of the patient's diet and nutrition, "which often receive limited attention."
In one study of Medicare-eligible patients, 20% had an average intake of fewer than 50% of their energy requirements, which could be because their procedures require they eat nothing for certain periods, which are prolonged when the tests or procedures need to be rescheduled.
"These deficits, rarely addressed at discharge, can lead to protein-energy malnutrition," Krumholz wrote. And that can lead to loss of weight and decreased blood albumen levels that are "strong predictors of readmission within 30 day," he wrote.
Malnutrition can impair wound healing, raise risk of infection, exacerbate pressure ulcers, decrease respiratory and cardiac function and result in poorer outcomes for lung disease.
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Comments are moderated. Please be patient.
Mary Mammarella (1/18/2013 at 12:31 PM)
This reminded me of an article I read some years ago about physicians who treated people who had been tortured and were trying to recover. I am NOT accusing anyone of torture, but rather suggesting there might be something to learn from those physicians. When you look at the items sited like sleep deprivation, nutrition, pain, etc., it is hard not to connect the patient's reaction to hospitalization to the reactions of released prisoners or victims of torture. Thanks for the article.
Sharon Del Favero (1/16/2013 at 1:18 PM)
A very good argument for a holistic approach to patient care which currently contradicts the "focus only on the admitting diagnosis". While methods of reimbursement see this focus as less costly I would challenge is it really in the big picture? each disease state impacts another if present within the same patient..... does it not?
debra reynolds (1/16/2013 at 11:37 AM)
Sleep deprivation, and feeling alone and out of control of your circumstances can be scary for patients. Healing happens when a patient is at at peace. Explain to the patients in their language and their pace the procedures, lag-times etc. Use volunteers to keep them company in their rooms, if they want one. A little courtesy can go a long way towards recovery.