Justin Ide for The Wall Street Journal If you wind up in the hospital, there’s a good chance you’ll be making a return trip. As an article in this morning’s WSJ reminds us, about 20% of Medicare patients are readmitted within a month or so of discharge. Now the feds are looking to drive down readmissions by penalizing hospitals with high rates. The idea is to give hospitals a financial incentive to keep patients out of the hospital, which could in turn lower overall health costs. So many hospitals may soon be following the lead of those facilities that have been making a concerted effort to keep people from coming back. The key takeaway: To drive down readmission rates, hospitals have to follow their patients home and get involved in their lives in the outside world. The WSJ tells the tale of a hospital in western Massachusetts that’s been pushing for a while to reduce readmissions for patients with heart failure, a chronic condition where the heart isn’t pumping as well as it needs to. The hospital’s efforts range from installing high-tech monitors in patients’ homes to telling patients to lay off the hot

dogs at Fourth of July picnics, because the high sodium content could cause problems. Heart failure is an key condition to watch in the readmission story for a few reasons. Readmission rates are particularly high for heart failure patients — about one in four is readmitted in 30 days. Heart failure patients often have multiple, chronic conditions, so they’re indicative of the type of complex patient that often struggles in our fragmented health-care system. They often see multiple specialists who may not be aware of all the different drugs the patient is taking, and it may be difficult for the patient to coordinate his or her own care. What’s more, certain signs — such as sudden weight gain — can be a sign of imminent trouble, and quick, relatively simple interventions can prevent re-hopsitalization. The trick is some combination of teaching the patients to care for themselves, and working to take better care of them when they’re out of the hospital — the two big issues at the core of driving down readmission rates for a wide range of patients.

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Heart Failure, Hot Dogs and Hospital Readmissions