Hebrew Rehabilitation Center (HRC), an affiliate of Harvard Medical School, recently released a study in June demonstrating a decreased rehospitalization among senior patients following implementation of a three-point intervention method. Recent years have shown a rise in rehospitalization of seniors within 30 days of their discharge from a skilled nursing facility, says the study, and estimates put costs for this at more than $17 billion annually.
However, HRC believes this can be reduced by utilizing the intervention, which combines standardized admission templates, palliative care consultations, and root-cause-analysis conferences. The study, published in the Journal of the American Geriatrics Society, consists of before-and-after analyzation of the implementation in HRC’s Recuperative Services Unit; the rate of patient rehospitalization fell from 16.5% to 13.3%, and discharges to home increased to 73%, up from 68.6%, says HRC.
“The change in discharge disposition observed between the two periods, we believe, reflects an improvement in patient outcomes,” says lead author Randi E. Berkowitz, M.D., a geriatrician at Hebrew Rehabilitation Center and medical director of the Recuperative Services Unit. “Specifically, a lower acute transfer rate likely reflects improved processes of care in the skilled nursing facility.”
HRC cites recent estimates of $17.4 billion in costs incurred as a result of 20% of Medicare beneficiaries being rehospitalized within 30 days of their discharge. It mentions that readmission to hospitals often has a negative effect on senior patients and can lead to a steady decline in functional status; this in turn may effectively end seniors’ independence and force them into a long-term care facility. The intervention, when implemented at HRC, caused long-term care discharges to drop to 11.5%, down from 13.7%.
The three intervention methods are timely, as October 2012 marks the end of Medicare paying hospitals for preventable readmissions as part of a national health-care reform legislation.
Written by Alyssa Gerace