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Lowering your risk of readmission

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June 26th, 2014

One of the major challenges of being hospitalized is something we often don’t think about: the risk of being rehospitalized shortly after being discharged to your home or a rehabilitation facility. It turns out that up to 20% of seniors—as many as one in five—are rehospitalized within 30 days of leaving the hospital. 

This may seem surprising because the assumption is that going home means you’re better and will remain so. The reality is you are typically discharged early in recovery and there remains substantial risk for becoming ill again. After a hospitalization, you are likely to be weak and at increased risk of falls and injury. It is not uncommon to have a decline in a chronic condition such as diabetes or heart disease even though that condition was unrelated to the reason for hospitalization. There are often new medications or changes in your regime, which can result in side-effects and drug interactions. 

Generally, your condition changes on a daily basis during the initial weeks following an acute illness. This requires close follow-up and communication and that, quite simply, is the key to avoiding a return to the emergency room or hospital. 

While communication and a seamless transition may seem straightforward, it remains one of the greatest challenges in medicine today and, when done poorly, often leads to readmission. Some of the many reasons for unsuccessful transition include no follow-up appointment, no follow-up on pending tests at the time of discharge, inability to fill new prescriptions, and inadequate discharge instructions. Fortunately, many health care systems have focused on transition and our national readmission rate has declined to 17.5% down from 20% a few years ago. 

Keep your primary care doctor in the loop

The primary care doctor plays a crucial role during and after hospitalization. First, you or a loved one should notify your primary care doctor immediately if you are admitted. Stay in touch during the hospitalization and then set up a follow-up appointment before you leave the hospital. This is a critical step in avoiding readmission as many studies show higher rates when follow-up appointments don’t occur shortly after the acute hospital stay. 

Always read your discharge instructions carefully and have a plan in place to follow them; it may help to make or ask someone to create a daily medication schedule. Plan ahead of time for how you will handle daily tasks. Hospital staff, such as discharge planners, social workers, and nurses, can also help and do most of the footwork such as obtaining assistive equipment or setting up home health or home support, but ultimately the plan will be yours to follow.

Hospitalizations are difficult, often painful experiences that affect both your physical and emotional health. You want to avoid a return visit, and the good news is that by following a few simple steps and communicating well, you can do just that.

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