One Key Step to Reduce Preventable Rehospitalizations

Reducing preventable readmissions in Chicago has a strong ally on its side. Dr. Marilyn Szekendi, PhD, RN, published a report last year in the Journal of Hospital Medicine that claims that hospitals need to make only one key step to reduce preventable rehospitalizations, and it required identifying common traits across all, or most, patients.

Dr. Szekendi is the director of quality research at University Health System Consortium in Chicago, otherwise called UHC. She says that observing that different traits and characteristics that are shared among those that frequently admitted to the hospital can pave the road to finding a solution to unnecessary rehospitalizations in Chicago, and beyond. Frequent hospital admissions are defined as being admitted to the hospital more than five times in a given year.

For the study, UHC worked with an alliance of affiliate hospitals and nonprofit medical centers to conduct the study. The group studied more than 28,000 patients who were admitted from 2011 to 2012 for a combined 180,185 times to academic medical centers, like the ones at the University of Chicago and University of Illinois Chicago (UIC), but this study included similar institutions from across the country. Although the patients in the study made up only 1.6 percent of all patients, they comprised more than 8 percent of all admission and 7 percent of direct costs.

The study provides hope of solving preventable rehospitalizations because the scientists and doctors who wrote this report believe that this type of analysis can easily be conducted in any medical institution.

The study also revealed the common factors that are linked to frequent readmissions. Patients with comorbidities are readmitted an average of 7.1 times versus 2.5 in a control, and 84 percent of those admissions are for medical services. They also found that patients who have Medicaid or are completely uninsured are also more likely to be readmitted to the hospital, 27.6 percent versus 21.6 percent of those who have private insurance.

Dr. Szekendi wants to expand this study to observe other factors that they were previously unable to collect data for, and she believes that that will reveal even more solutions to preventable rehospitalization. These factors include housing status, preexisting access to medical care, and other key lifestyle indicators.

Although there is still a while to go before the collected data can paint a picture clear enough to indicate proper course of action, but we do have the tools to reduce unnecessary readmissions. Extending post-hospitalization treatment and rehabilitation at a short-term nursing facility has been proven to dramatically reduce rehospitalization and set the patient up for successful rehabilitation, to get back to regular life quicker and safer.