Emergency Department Visits Drive Up Readmission Rates Far Higher than Originally Presumed
Another article caught my attention last week. It was an article in HealthLeaders on a report issued as part of the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project, which covered 12 states including Arizona, California, Florida, Hawaii, Massachusetts, Missouri, Nebraska, New Hampshire, New York, South Carolina, Tennessee, and Utah.
The key finding of the report was that the problem of readmissions and use of emergency room resources is more problematic than originally presumed.
According to the AHRQ report, “most readmission studies only report information on patients who have multiple hospital inpatient stays,” and in so doing exclude patients who seek care in the emergency department (ED). Once the researchers included ED visits, the rate of multiple visits jumped by more than one-third—from an average of 1.5 to 2.1 acute care hospital visits per patient.
The report’s database includes 27.8 million inpatient stays, or 15.1 million patients. According to the report, “more than a quarter of these patients, or 27.2%, had multiple inpatient stays in the two years, with an average of 1.5 stays per patient.” Approximately four in 10 patients who sought acute care during the period studied (2006 to 2007) made multiple visits to the hospital either for an inpatient stay, an emergency visit, or both.
The HealthLeaders article goes on to say, “The report is one of numerous studies underway to determine the extent to which patients are treated and discharged, but then are readmitted for care for the same illnesses, which strains healthcare resources. In many cases, they [readmissions] may be avoided with closer care and monitoring after the patient goes home.”
Sound familiar? Pharos’ mission for the past 16 years has been to find simple and effective ways to reduce ALL hospital readmissions for chronically ill patients, and by that we mean inpatient and emergency department visits. By monitoring patients and keeping them healthier and out of the hospital, we have helped payers and providers save millions of dollars in healthcare costs. And as the new healthcare law mandates, keeping patients healthier and saving money on runaway costs will be rewarded.
An article published last year in April in the New England Journal of Medicine (Jenks, et al) analyzed Medicare claims data from 2003–2004 to look at patterns of rehospitalization. That study found that almost one fifth (19.6%) of the 11,855,702 Medicare beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34.0% were rehospitalized within 90 days.
The NEJM researchers’ estimated cost to Medicare for unplanned rehospitalizations in 2004 was $17.4 billion, leading them to conclude that rehospitalizations among Medicare beneficiaries are prevalent and costly.
The AHQR report notes that “devising effective strategies to reduce the rate of multiple acute care hospital visits by the same person requires a thorough understanding of the factors that contribute to repeat visits.”
At Pharos we do understand the factors that contribute to repeat hospital visits, which is why Tel-Assurance has been so successful and that is borne out in the strongly validated studies that have shown our measured clinical improvement and financial impact.
