Does Your
Hospital Do A Good Job?
By Carolyn M.
Clancy, M.D.
November 3, 2009
What if you
bought a used car and it broke down just a few
days after you drove it home? That would be
frustrating and costly, at the very least.
Now, imagine if
just days after you were sent home after a
hospital stay you ended up right back there.
Unfortunately, this situation happens more often
than it should.
Thanks to an
easy-to-use Web site called
Hospital Compare, you can now find out how
often patients treated at your hospital end up
returning within 30 days of going home.
Why is this
important?
These
"readmission rates" are good clues for the
hospital’s overall care quality. Low readmission
rates typically mean that good patient care was
given during the first hospital stay, and that
important information for post-hospital care was
communicated effectively. Low rates also may
mean that patients got the right care at the
right time from doctors, nurses, and other
providers based on the latest knowledge in
treating the condition. Checking these rates on
Hospital Compare, a tool from Medicare, is a bit
like kicking the tires of your local hospital.
That’s important,
because readmissions are too common and costly.
A recent study found that one in five Medicare
patients goes back into the hospital within a
month of his or her first stay. Only 10 percent
of those return visits were planned.
Readmissions
carry high price tags, too. For instance, in
2004 Medicare paid $17 billion for unplanned
return hospital stays. Your health and wallet
also pay a price when you repeat a trip to the
hospital.
Many readmissions
can be prevented, according to research from my
Agency, the Agency for Healthcare Research and
Quality (AHRQ). We found that hospitals can cut
their readmission rates if they do a good job of
explaining medical information and the next
steps to expect before patients go home. My
agency supported development of a
checklist for hospitals
that helps deliver that essential information to
patients.
There are also
steps you can take to prevent an unnecessary
return to the hospital.
You can check
your
hospital’s performance. Hospital Compare
provides you with information on more than 4,000
hospitals. Based on standards used to measure
quality, the Web site tells you how well a
hospital cares for patients with certain medical
problems or who need certain surgeries. It also
contains
patients’ ratings on the care they received
during their hospital stay.
The site recently
added information on how many patients with
heart failure, heart attack, and pneumonia end
up back in the hospital within 30 days of being
sent home. This information tells you how your
hospital stacks up against the national rate.
You can also help
prevent an unnecessary hospital return by:
-
Asking questions about your condition
and knowing what procedures and tests will
be performed.
- Making an
appointment with your primary care doctor
for follow-up care after you leave the
hospital.
- Asking
questions about your medicines and their
side effects, including which medicines you
should take and which ones you should stop
taking. Often hospital admissions lead to
changes in medications you were taking
before the admission. Making sure you
understand the changes is really important.
The Centers for
Medicare and Medicaid Services offers a useful
hospital discharge planner checklist (PDF
file, 463 KB;
PDF
Help) for patients and their caregivers.
Don’t assume your hospital will give you this
information before you leave. My Agency found
that one in five patients leaving a hospital
never got written information about which health
problems to watch for.
Knowing how your
hospital performs is important for you to make
good decisions about the health care you need.
It also helps you to understand whether you are
getting good value for your money. That’s
information worth having.
I’m Dr. Carolyn
Clancy, and that’s my advice on how to navigate
the health care system.
More Information
AHRQ
Podcasts
 Care
Transitions-What You Need to Know (Transcript)
Podcast Help
New
Web Site Helps Consumers Navigate the Health
Care System (Transcript)
Podcast Help
Agency
for Healthcare Research and Quality
Questions are the Answer
http://www.ahrq.gov/questionsaretheanswer/
Department of Health and Human Services
Hospital Compare
http://www.hospitalcompare.hhs.gov/
Centers
for Medicare and Medicaid Services
Planning for Your Discharge: A Checklist for
Patients and Caregivers Preparing to Leave a
Hospital, Nursing Home, or Other Health Care
Setting
http://www.medicare.gov/Publications/Pubs/pdf/11376.pdf
(PDF file, 463 KB;
PDF
Help
Boston
Medical Center
Project RED (Re-Engineered Discharge)
http://www.bu.edu/fammed/projectred/index.html
Current as of November 2009
Internet Citation:
Does Your Hospital Do A Good Job?
Navigating the Health Care System: Advice
Columns from Dr. Carolyn Clancy, November 3,
2009. Agency for Healthcare Research and
Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc110309.htm
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