Nobody wants to spend unnecessary time in a hospital, so when doctors tell patients they are ready to leave patients usually agree. But national studies from 2015 show that doctors are often wrong, and hundreds of thousands of patients are readmitted to hospitals soon after discharge.
Hospital readmission rates count the number of patients that are readmitted to hospitals within a specified time period after discharge from an earlier hospitalization. Typically that time period is 30 days. Patients may be readmitted to any hospital, not necessarily the same one, for any condition to count in this statistic.
The National Hospital Readmission Rate
A new study shows that the national average for hospital readmissions is 15.4%, down from 16% in 2011. Hospital readmission rates in Maryland usually fall above the national average, and the new study confirmed the state still does. The 2015 readmission rates in Maryland are just above 16%, down from 18.2% in 2011.
Early Hospital Discharge Leads To More Frequent Readmission
Early discharges occur for a number of reasons. Often the hospital or doctor in charge is busy and misjudges a patient while trying to keep up with an influx of patients. The University of Maryland found that patients discharged during the busiest time of a hospital were twice as likely to seek readmission within three days.
Hospitals also discharge patients for money: new patients mean new surgeries and procedures paid for by healthcare companies. Health care policy makers are working to change these incentives.
Patients can also be discharged too early simply because the doctor mistakenly thought the patient was ready. Before discharging a patient, doctors are required to follow strict guidelines that should include discussing the discharge with the patient and the patient's family, educating the patient about their condition and treatment plan, and reviewing the effectiveness of the treatment provided. Before discharge doctors should also assess factors such as:
- Cognitive status of the patient
- Physical functioning level of the patient
- Ability to continue treatment at home (access to medication, the condition of the patient's home in relation to recovery)
- Availability support of family and friends
- Patient's access to transportation
If doctors failed to assess the patient, schedule follow-up visits or failed to treat an underlying condition in the patient, it may be considered malpractice.
A study of hospital readmissions for patients initially admitted for heart failure, acute myocardial infarction, and pneumonia found that within 30 days 24.8% of the heart failure patients, 19.9% of the myocardial infarction patients, and 18.3% of the pneumonia patients were readmitted. The majority of each group was readmitted for the same condition meaning patients were not cured when they left the hospital the first time. Other illnesses that commonly end in hospital readmissions include elective knee and hip replacements and chronic lung conditions.
Patients should be able to trust that their doctors will not discharge them from the hospital without good reason. When patients are uncomfortable with a discharge order, they should talk to their doctors and to hospital managers about proper procedures and checklists, and make sure that discharge is the best decision for their health.