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The Hospital Readmission Problem in the US
By Lubna Rashid
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Emergency Department Readmissions
Major burden on health system. Costs about $ 15B annually.
Percentage occurrence ≈ 20%
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Factors
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Variable P-Value
Age .000
Urgent Condition .001
Neuroses .000
Congestive Heart Failure
.027
Chronic Obstructive Pulmonary Disease
.000
Dysponeas .000
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Problem
Poor Access to Primary Care
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Lack of equity in primary care distribution
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Lengthy waiting times in primary care facilities
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Survey:
Many patients prefer receiving care from the ED rather than primary care.
Why?
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Solutions?
better access to alternative health services
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Optimizing access to specialized clinics or centers for particular health conditions to
provide better primary care(i.e. location, waiting time)
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Better health care coordination and management
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Patient choice of ED over primary care should be further investigated
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Further Suggestions
Provide incentives for patients to seek primary care
(e.g. Transportation)
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Educate the patients about the readmission problem.
“Hospitals are dangerous places”
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financial incentives to primary care facilities to increase coordination and
enhance care quality
(A similar STAAR initiative for primary care)
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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
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Result
Patients favor primary care for follow-up rather than ED readmission
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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