Decreasing Avoidable Hospitalizations through Home Care

Perhaps the most publicized topic is hospital readmission rates.  In 2007, MedPAC reported that “17.6% of admissions result in readmissions within 30 days of discharge, accounting for $15 billion in spending.  Not all of the readmissions are avoidable, but some are” (MedPAC, June 2007, p. 103).

The majority of hospital readmission costs are associated with four distinct medical conditions, which lead to over $1.6 billion in spending on readmissions alone.  These conditions include heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, and acute myocardial infarction (AMI) (MedPAC, June 2007, p.116).  Granted these numbers are based upon 2005 Medicare hospital discharges and they could be even higher in 2011.

Hospitals currently report on re-admissions for patients discharged with one of three particular principal diagnoses:

1. AMI
2. Heart failure
3. Pneumonia

National averages for hospital readmissions as of August 5, 2011, were still over 15% at 19.8, 24.8 and 18.4% respectively (U.S. Department of Health and Human Services, August 5, 2011).

Home care hospitalization outcomes are reported with a national average of 26% (U.S. Department of Health and Human Services, July 21, 2011).  The Delta Study to Reduce Hospitalizations:  A National Study to Re... will identify practices used by the most successful home care agencies to help reduce their rate of avoidable hospitalizations.  The Delta Study to Reduce Hospitalizations report will be shared with the home care industry at large in February 2012.

While physicians’ quality measures do not focus on hospital admission specifically, the focus is on interventions and treatment to prevent disease, disease progression, and ultimately avoiding hospitalization.