How do we improve the quality and efficiency of health care within the U.S. with a special emphasis on improving coordination of care within hospitals?
Examine the rate of hospital readmissions
Across the U.S., many Medicare beneficiaries rely on hospitals servicing low-income areas for their care, placing additional financial pressure upon the institution. It is reported that each year within the U.S. one of five Medicare recipients returns to the hospital within 30 days of discharge, roughly costing the program $18 billion (Mittler et al., 2013). Many of these readmissions are for conditions that are thought be preventable had patients received the proper ...view middle of the document...
, 2013). Interventions within these programs include heightened admission assessments, effective teaching and learning, patient and family-centered discharge communication, and posthospital care follow-up with initiatives such telephone check-ups.
Within the south suburban areas of Chicago, IL, two comparable larger hospital facilities, Advocate South Suburban and Ingalls Memorial, both service lower income areas with a large Medicare patient population. For the fiscal year of 2011 as reported by the Illinois Department of Public Health (2014), the majority of inpatient insurance coverage for both facilities was Medicare with Advocate South Suburban reporting 43.25% and Ingalls 41%. As reported by the official government website for Medicare (2014), between the dates of 2008 and 2011 the rate of readmissions within 30 days for Advocate South Suburban were as follows-
• Pneumonia patients- 21%
• Heart failure patients- 25.2%
• Heart attack patients- 19%
For the dates of 2008 to 2011, the rate of readmissions within 30 days for Ingalls Memorial were also reported as follows-
• Pneumonia patients- 21%
• Heart failure patients- 27.8%
• Heart attack patients- 22%
Hospitals readmission rates are able to provide insight into the important measurement of the quality and cost of healthcare being provided. While factors outside of the hospital may contribute to unplanned readmissions, the frequency of readmissions occurring within 30 days of discharge suggests room for improvement in the quality of inpatient care and discharge planning. The Centers for Medicare and Medicaid Services, along with the Agency for Healthcare Research and Quality, developed the Hospital Consumer Assessment of Healthcare Providers and Systems survey, or better known as HCAHPS (Boulding, Glickman, Mannery, Schulman, & Staelin, 2011). The HCAHPS survey is a national, standardized survey given to randomized samples of discharged patients asking about their hospital experience. As presented by the Centers for Medicare and Medicaid Services (Boulding et al., 2011), questions asked within the survey covers the following ten topics:
• How often did nurses communicate well with patients?
• How often did doctors communicate well with patients?
• How often did patients receive help quickly from hospital staff?
• How often were patients’ pain levels controlled well?
• How often did staff explain about medicine...