At the top of the list of needed reforms for senior health care is creating better procedures for discharge them after a hospitalization. Too often patients are not given enough directions, directions spelled out clearly enough or follow-up care with medical personnel checking on their home progress. While we wait for the recommendations of innovators like Eric Coleman, MD, MPH, Professor of Medicine within the Divisions of Health Care Policy and Research and Geriatric Medicine at the University of Colorado, to be implemented on a wide scale, we will continue to see studies like the one just published in the journal Circulation. After studying discharge records from Medicare patients hospitalized with heart failure between 2004 and 2006, lead researcher Joseph Ross, MD, of Mount Sinai School of Medicine in New York found that nearly a quarter—23 percent—of these patients were back in the hospital within just a month of their discharge. One easily remedied reason was a lack of basic written instructions for following a healthy diet and exercise plan and taking medication they were prescribed. Figures from the American Heart Association estimate that over 5 million Americans have heart failure, treatment for which will cost nearly $35 billion in 2009, an amount that could be reduced if hospital readmissions were reduced. The conclusion? To deliver better care, this US medical system needs to focus more on paying doctors to keep patients out of the hospital rather than only caring for them when they are sick.
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