Readmissions May be Triggered by 'Post-Hospital Syndrome'

Cheryl Clark, January 15, 2013

As hospital teams zealously work to prevent 30-day readmissions, they may not realize that sometimes what brings patients back into their hospitals is not what brought them there in the first place.

Something else is going on. Writing in the New England Journal of Medicine, Harlan Krumholz, MD, calls it "post-hospital syndrome, an acquired transient condition of generalized risk."

The syndrome, he said, is making patients sick with a variety of other conditions after their primary illnesses are resolved, although it's unclear why.

In fact, hospital officials are aware that 20% of Medicare patients discharged from a hospital have a medical problem within the next 30 days that is so serious, they must be re-hospitalized.

Typical readmitting diagnoses include mental illness, gastrointestinal conditions, metabolic derangements, and trauma, as well as heart failure, pneumonia, and chronic obstructive pulmonary disease.

Krumholz postulates that readmissions not related to the index admission might be due as much to otherwise unexplained "allostatic and physiological stress that patients experience in the hospital just as they do from the lingering effects of the original acute illness."

And hospital teams need to work harder to explore "new approaches to making hospitalization less toxic."


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