It’s open enrollment season for Affordable Care Act health insurance! Here are 11 things you need to know.
by Carolyn M. Clancy M.D., AHRQ, AARP Bulletin, November 4, 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 website 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 about the hospital’s overall care quality. Low readmission rates typically mean that the patient received good care 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 website tells you how well a hospital cares for patients with certain medical problems or those 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:
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 & Medicaid Services offers a useful hospital discharge planner checklist for patients and their caregivers. Don’t assume your hospital will give you this information before you leave. The Agency for Healthcare Research found that one in five patients leaving a hospital never got written information about health problems that might occur.
Knowing how your hospital performs is important for helping you 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.
Carolyn M. Clancy, a general internist and researcher, is the director of the U.S. Agency for Healthcare Research and Quality.
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