A new study published this week in the New England Journal of Medicine concluded that one in five Medicare patients ends up back in the hospital within a month of discharge, a practice that costs billions of dollars a year.

 

For the study, researchers at the University of Colorado in Denver looked at Medicare records from late 2003 through 2004. They found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge and about a third were back in the hospital within three months.

 

Overall, patients with heart failure and pneumonia had the most readmissions. Also patients undergoing surgical procedures such as cardiac stent placement, major hip or knee surgery, vascular surgery, major bowel surgery and other hip or femur surgery had the highest returns.

 

“Rehospitalization is a frequent, costly, and sometimes life-threatening event that is associated with gaps in follow-up care,” the study says.

The researchers estimated that unplanned return visits accounted for $17.4 billion of the $102.6 billion that Medicare paid hospitals in 2004.

 

“It's a big hunk of money and it's a big hunk of misery,” Dr. Stephen Jencks, an independent consultant who worked for the Centers for Medicare and Medicaid Services said. He was one of the three authors of the study.

 

In an editorial accompanying the study, Harvard's Dr. Arnold Epstein said the high rates may be in part from inadequate coordination of care and poor discharge planning, since half of the patients who were readmitted within 30 days had no ambulatory visit before the rehospitalization.