Researchers urge a broad-based approach to cut Medicare rehospitalizations

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Efforts to reduce the rehospitalization rate for older patients should not strictly focus on measures tied to particular diseases or diagnoses, researchers recently proposed.

Columbia University Medical Center researchers issued their recommendation after analyzing 2007-2009 data related to rehospitalization rates of about 3 million Medicare patients who were initially admitted for heart failure, acute myocardial infarction (heart attack) and pneumonia.

Within 30 days of discharge, 24.8% of heart failure patients were readmitted, researchers found. The rate was slightly lower for heart attack (19.9%) and pneumonia (18.3%).

In many cases, rehospitalization was due to a different condition than the one that caused the initial admittance. For example, recurrent pneumonia accounted for only a quarter of the rehospitalizations among initial pneumonia patients. What this means is long-term care providers have to treat patients holistically rather than zero in on a specific illness, researchers said.

“This heightened vulnerability of recently hospitalized patients to a broad spectrum of conditions throughout the postdischarge period favors a generalized approach to preventing readmissions that is broadly applicable across potential readmission diagnoses and effective for at least the full month after hospitalization,” the researchers wrote. “Strategies that are specific to particular diseases or periods may only address a fraction of patients at risk for rehospitalization.”

The results of this study – “Reasons for and Timing of Readmission for Older Patients Following Hospitalization for Heart Attack, Heart Failure, or Pneumonia” – were published in the January 23 The Journal of the American Medical Association, which focused on the issue of rehospitalization.