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Out of the hospital and into the E.R.

Out of the hospital and into the E.R.

If you recently checked out of a hospital there’s a good chance you’ll be heading back soon, quite possibly through the emergency room door. Nearly 10 of every 100 hospital patients enter the emergency room within 30 days of their discharge, and another 15 are actually admitted back into the hospital for at least one night.

That’s one of the findings of several studies related to hospital readmissions in the current issue of the Journal of the American Medical Association. The topic is getting so much attention in large measure because last October the Centers for Medicare and Medicaid services began penalizing hospitals for excessive readmission rates. So far, more than 2,000 hospitals have already lost money as a result, to the tune of about $300 million. And that could triple next year, when additional provisions of the Affordable Care Act kick in.

“Readmission to the hospital often means an individual’s health care system has failed,” says John Santa, M.D., director of the Consumer Reports Health Ratings Center. “The patient and the health system need a reassessment and treatment.”

Patients who had undergone angioplasty (percutaneous coronary intervention) with drug-eluting stents, and those who had complicated hip and thigh surgeries, were most likely to have to return to the hospital for emergency care: almost 25 percent of them did so.

Another study in the same issue found that readmissions is a problem not only for adult patients, but pediatric ones, too. If found that 6.5 percent of children released from the hospital return within a month.

In both cases, the studies found large variations among hospitals, with readmissions much more likely in some hospitals than others.

Our investigation of hospital safety found similar patterns. See our hospital Ratings and our report on pediatric intensive care units for details. And see our advice on how to stay safe in the hospital.

Use of Hospital-Based Acute Care Among Patients Recently Discharged From the Hospital [JAMA]
Pediatric Readmission Prevalence and Variability Across Hospitals [JAMA]

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