The Serious Problem of Re-Hospitalizations
A patient is usually discharged from a hospital when the patient’s physicians believe that the patient’s condition can be adequately managed outside of the hospital. Most patients greet the news of an impending discharge with joy and are excited to be free from the constant monitoring and restrictions of hospital life. Few patients are eager to reenter the hospital any time soon. However, unplanned returns to the hospital are all too common and present significant health risks for patients.
Common Reasons for Unplanned Returns to the Hospital
Patients often leave the hospital with plans for continuing care, rehabilitation therapy or a return to normal life. They plan for their future based on their needs at the time of their discharge and few, if any, anticipate a repeat hospitalization in the near future. However, all patients should be aware of some factors that could lead to a repeat hospitalization including:
- Premature discharge: some patients are encouraged or required to leave the hospital before they are medically ready. There are several reasons for these premature discharges. One is that many insurance companies require a shorter hospital stay for patients than what many doctors and hospitals recommend. If a patient’s insurance company will not pay for a longer hospital stay then many patients are financially forced out of the hospital because they would not be able to pay the additional medical costs. Some patients are also forced into short hospital stays because of patient overcrowding. As more and more community hospitals close due to the costs of operating these facilities, the remaining hospitals are becoming overcrowded and may be discharging patients too soon to deal with the crowding problem.
- Changes to medication: patients, particularly elderly patients or those with chronic medical conditions, may enter the hospital on a certain medication regime. Often, changes to that medication regime are initiated by the doctors in the hospital based on the reasons for the hospitalization. For some patients, this results in adverse drug reactions or in adverse drug interactions that can lead to adverse drug events requiring a re-hospitalization shortly after discharge.
- Inadequate visiting nurse or home health care aid: many patients are discharged from the hospital with the understanding that they will receive at least short term care from a visiting nurse or a home health care aide. If those services are insufficient to meet the needs of the patient or if the services are not properly provided then the patient may endure a medical setback that requires another hospitalization.
Reasons to Prevent Repeat Hospitalizations
There are several reasons why it is important to prevent repeat hospitalizations. Patients and their families should be aware that re-hospitalizations bring with them an increased:
- Danger: the situation that results in the subsequent hospitalization presents a medical risk to the patient. Otherwise, the patient would not need to be hospitalized.
- Risk of Secondary Infection: hospitals are germy places. While people do go there to get better and most hospitals are kept as sterile as possible, germs abound. For example, staph infections that may be difficult to fight can be contracted in hospitals. These types of infections can be particularly dangerous for the elderly or chronically ill who may not be able to effectively fight infections.
- Level of Inconvenience: being in the hospital is inconvenient. It means time away from work, family and other obligations in order to recover in the hospital.
Many repeat hospitalizations and the risks inherent in those repeat hospitalizations are preventable. However, until the common and preventable reasons for repeat hospitalizations are adequately addressed the risks associated with repeat hospitalizations will continue to adversely affect many Americans each year.