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After Hospital Discharge, Other Ills May Land Seniors Back in Again
Date:1/9/2013

member the things you tell them," Krumholz noted -- whether it's from sleep deprivation, medication side effects or other reasons.

Previous research has shown that about 20 percent of older Americans on Medicare are readmitted to the hospital within 30 days. And more often than not, that return trip is not for the illness that originally landed them in the hospital. Instead, infections, accidents and gastrointestinal disorders are among the common reasons.

Take heart failure, for example. It is a common cause of hospitalization for older Americans, but when those patients are readmitted within 30 days, heart failure is the cause only 37 percent of the time, according to a study previously published in the New England Journal of Medicine.

One expert, Dr. Amy Boutwell, said the editorial underscores a "very important" point.

"We have to think about discharge from the hospital in a whole new way," said Boutwell, president of Collaborative Healthcare Strategies Inc., which works on projects to improve care and prevent hospital readmissions.

"The good news is most hospitals across the country are now paying attention to this," said Boutwell, who is also an internist at Newton-Wellesley Hospital in Newton, Mass.

For several years, programs have aimed to cut avoidable hospital readmissions. Boutwell co-founded one, called STAAR (State Action on Avoidable Rehospitalizations), which involves hospitals in Massachusetts, Michigan, Ohio and Washington state.

And hospitals now have a financial motivation to cut readmissions, Boutwell added. Last year, Medicare began penalizing hospitals with higher-than-expected rates of readmission within 30 days of patients' original stay.

Hospitals vary in the specific steps they take to reduce readmissions, Boutwell said. But one example is that centers are trying to ensure that families understand what has to happen when the patient goes home, and helping them with "logistics" -- such
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