To avoid a return trip to the hospital, take action before you are discharged

March 12, 2012

When you leave a hospital after an illness, you hope that your days there will soon be a distant memory. But that’s not always the case. Roughly one Medicare patient in six, for example, is readmitted within a month of being discharged, according to a report last year by the Dartmouth Institute for Health Policy and Clinical Practice. But a majority of readmissions could be prevented with proper follow-up care. While your hospital team cares for you there, it’s on you to take over at home. Here’s how:

Compare hospitals

In Consumer Reports’ latest hospital ratings, 70 percent of the facilities earned the lowest or second-lowest rating for total readmissions. To make some comparisons, go to hospitalcompare.
hhs.gov
, which includes readmission rates.

Schedule follow-up appointments before being discharged

“Seeing a physician or nurse within two weeks of leaving the hospital leads to better health outcomes and fewer readmissions,” says David Goodman, a professor of community and family medicine at the Dartmouth Medical School and a principal investigator of the 2011 report. Goodman found that more than half of the Medicare patients 65 and older failed to see a doctor within that time frame. Follow-up visits should be easy to schedule, especially if you’re a member of an integrated health system that shares records and information among providers.

Ask if your hospitaloffers tele-monitoring

This technology allows your vital signs to be checked while you’re at home. It’s especially important if you have a chronic condition such as diabetes or hypertension, which can double your risk of an unplanned readmission, according to a report by the Congressional Research Service, a nonpartisan arm of Congress.

Get plans in writing

Medicare regulations require hospitals to have a process for all patients to receive written discharge instructions, including lists of follow-up appointments, medication and dosage directions. But according to the CRS report, those plans are often incomplete. Before entering a hospital, print a sample discharge plan (you can find one at www.
ahrq.gov/qual/goinghomeguide.
pdf
) and have your hospital care team complete it. Bring it to follow-up visits, Goodman suggests.

Fill prescriptions right away

A recent study looked at patients who had surgery to insert a coronary stent. It found that the risk of a heart attack or death over the next 30 days was nearly twice as high among those who didn’t fill their prescription for a blood thinner within 24 hours of being discharged than among those who took their medication promptly.

Lean on friends and family

Research suggests that patients who have the support of family and friends are less likely to be readmitted to a hospital. If you’re alone, the hospital should provide a list of home health agencies or facilities that can help you at home.

If you’re not ready
to go, say so

You shouldn’t go home if you feel disoriented, faint or unsteady; if you have pain that’s not controlled by oral medication; if you can’t go to the bathroom unassisted; if you can’t urinate or move your bowels; or if you can’t keep down food or drinks.

Copyright 2012. Consumers Union of United States Inc.

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