The Hospital Readmission Problem in the US

By Lubna Rashid

Emergency Department Readmissions

Major burden on health system. Costs about $ 15B annually.

Percentage occurrence ≈ 20%

Factors

Variable P-Value

Age .000

Urgent Condition .001

Neuroses .000

Congestive Heart Failure

.027

Chronic Obstructive Pulmonary Disease

.000

Dysponeas .000

Problem

Poor Access to Primary Care

Lack of equity in primary care distribution

Lengthy waiting times in primary care facilities

Survey:

Many patients prefer receiving care from the ED rather than primary care.

Why?

Solutions?

better access to alternative health services

Optimizing access to specialized clinics or centers for particular health conditions to

provide better primary care(i.e. location, waiting time)

Better health care coordination and management

Patient choice of ED over primary care should be further investigated

Further Suggestions

Provide incentives for patients to seek primary care

(e.g. Transportation)

Educate the patients about the readmission problem.

“Hospitals are dangerous places”

financial incentives to primary care facilities to increase coordination and

enhance care quality

(A similar STAAR initiative for primary care)

Internal medicine physician with a similar role to the hospitalist could be employed

in primary care facilities to enhance coordination and performance in the

clinics

Result

Patients favor primary care for follow-up rather than ED readmission

Summary

collaborative and multidisciplinary efforts from hospitals, primary care clinics, public health organizations, social

services, and the government are crucial to the improvement of primary care

utilization