Jan 23, 2019

Hospital Re-Admissions and the Elderly

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The New York Times is writing about the ACA’s Hospital Readmissions Reduction Program and the question of whether or not this is causing increased mortality among older patients.  This should be of increased interest to nursing facilities since the refusal of readmission after a nursing home sends a resident to the hospital and subsequent death of the resident when returned to the facility may increase scrutiny of the nursing home rather than the correctness of a hospital refusing re-admission.  The three serious ailments focused on by the Program are heart failure, heart attacks and pneumonia, conditions common among nursing home residents.  According to the article, readmissions have dropped since the institution of the program and it appears substantially. However,  the question posed in the article is as follows:

Now, it’s not so clear. Are readmissions for those conditions really dropping as substantially as it first appeared? Or has the program’s impact been overstated?

Are Medicare patients getting better care, or are they being kept out of hospitals to avoid readmission penalties? Are people getting hurt in the process?

Two studies, one published in Jama and one in Health Affairs cast doubt on improvement in care as a reason for the drop in readmissions, but rather responses by hospitals to the punitive aspects of the Program.


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