High Rate of Rehospitalizations Costing Billions

April 2 -- WEDNESDAY, April 1 (HealthDay News) -- One in five Medicare patients discharged from the hospital is readmitted within 30 days, while half end up back in the hospital within a year, a new study finds.

The groundbreaking research exposes a "frequent, costly and sometimes life-threatening" problem that researchers believe could be prevented through better care coordination. The study appears in the April 2 issue of the New England Journal of Medicine.

The message here for Medicare patients and their families: Be your own advocate to avoid landing back in the hospital.

"The things that may not feel right to you about the discharge process may not be right, and you should be prepared to stand up for what you need," said study author Dr. Stephen F. Jencks, former director of the Quality Improvement Group at the Centers for Medicare and Medicaid Services in Baltimore.

Not only do Medicare patients need to know how to care for themselves at home and who to call if they have a problem, they also need to make sure a follow-up appointment is scheduled with a physician before leaving the hospital, Jencks said.

In 2004, unplanned rehospitalizations cost Medicare an estimated $17.4 billion, the study authors noted.

President Barack Obama's 2009 budget proposal targets the problem through a combination of financial incentives and penalties. He would pay hospitals a "bundled" rate that includes inpatient care as well as certain post-acute care services provided 30 days after hospitalization. Hospitals with high readmission rates would be paid less if patients are readmitted to the hospital within the same 30-day period.

To date, most studies examining rehospitalization have focused on specific diseases, such as heart failure or chronic obstructive pulmonary disease.

"I think one of the strengths of the Jencks analysis is that he looks at all-cause rehospitalizations, and that's a unique and a new view," said Dr. Amy Boutwell, a general internist at Newton-Wellesley Hospital in Newton, Mass., and director of the Institute for Healthcare Improvement's reducing rehospitalizations initiative.