Reducing Hospital Readmissions among High-Risk Patient Populations

1 Reducing Hospital Readmissions among High-Risk Patient Populations Patients who have gone through a recent period of hospitalization experience a heightened risk of adverse health events compared to other people. Due to these health consequences, some people are likely to be readmitted to the hospital (Hughes & Witham, 2018).

Readmission to the hospital refers to the admission of a person to the hospital within thirty days of being discharged from a hospital stay. The readmission can be attributed to a health event different from the initial hospitalization. Readmission has significant consequences on an individual. Besides being used as an indicator of poor health outcomes, readmission increases the burden and costs of care. This possibility of being readmitted to the hospital is greater among certain populations than others. This discussion explores the impact of diabetes on individuals living in regions characterized by low literacy levels and poor socioeconomic status.

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2 A Diagnosis among a High-Risk Patient Population The high-risk population selected for this discussion is poor people from ethnic minority communities who live in poor neighborhoods. This population was selected since the people do not have the financial capability to implement health promotion and disease prevention interventions. Consequently, they suffer from a wide range of preventable and treatable conditions that result in hospitalization and readmission. Diabetes is one of the health conditions that affect a significant proportion of ethnic minority communities. Whereas those who are financially stable can implement healthier lifestyle interventions, the poor exemplify a lifestyle that further aggravates their health situations. Diabetes has been identified as a significant contributor to readmissions in this population. Studies show that proximately 14% of diabetic patients are readmitted to the hospital within three days of discharge (Rubin, 2015).

Felix, Seaberg, Bursac, Thostenson, and Stewart (2015) noted clearly that the chances of being readmitted are even higher among poor people with low literacy levels. Socioeconomic status and literacy rates influence the readmission of patients. Hospitals established with poor neighborhoods record significantly higher readmission rates than those in wealthy regions (Rubin, 2015). A lack of knowledge among these people further hinders their compliance with the treatment regimen. The conditions under which these people live make it impossible for them to comply with the care providers’ instructions. Further, patients living in overcrowded locations are less likely to get a follow-up appointment.

Intervention for Readmissions The most practical intervention for hospital readmissions is the creation of a concrete follow-up program. Hospitals need to implement a plan whereby patients are followed up for seven days after discharged. The results of the study by Bricard and Or (2019) revealed that the

3 readmission rate was significantly lower among patients who were followed by the primary care provider within seven days of discharge. The readmission rates were even lower when the findings were extrapolated to thirty days. Another potentially effective strategy for reducing readmissions is the establishment of a robust home health program (Deb et al., 2019). The purpose of this program is to enhance continuity of care. The presence of home health aides has been touted as a practical mechanism for preventing readmissions.

Conclusion Readmission to the hospital is doubtlessly a significant contributor to increased burden and cost of care. Some populations are more likely to experience readmissions than others. Further, chronic conditions such as diabetes augment the risk of readmission. A robust home health program, together with the establishment of a follow-up program, can reduce readmissions.

References Bricard, D., & Or, Z. (2019). Impact of early primary care follow-up after discharge on hospital readmissions. The European Journal of Health Economics, 20(4), 611-623. https://doi.org/10.1007/s10198-018-1022-y Deb, P., Murtaugh, C. M., Bowles, K. H., Mikkelsen, M. E., Khajavi, H. N., Moore, S., ... & Feldman, P. H. (2019). Does early follow-up improve the outcomes of sepsis survivors discharged to home health care?. Medical care, 57(8), 633-640. https://doi.org/10.1097/MLR.0000000000001152 Felix, H. C., Seaberg, B., Bursac, Z., Thostenson, J., & Stewart, M. K. (2015). Why do patients keep coming back? Results of a readmitted patient survey. Social work in health care, 54(1), 1–15. https://doi.org/10.1080/00981389.2014.966881

4 Hughes, L. D., & Witham, M. D. (2018). Causes and correlates of 30 day and 180 day readmission following discharge from a Medicine for the Elderly Rehabilitation unit.

BMC Geriatrics, 18(1), 197. https://doi.org/10.1186/s12877-018-0883-3 Rubin, D. J. (2015). Hospital readmission of patients with diabetes. Current diabetes reports, 15(4), 17.