Hospitalizations account for nearly one-third of the $2 trillion spent on healthcare in the United States annually. Nearly 20% of these hospitalizations are rehospitalizations occurring within 30 days of discharge. In 2008, there were 57,852 readmissions in Pennsylvania, amounting to approximately $2.5 billion in charges. Thirty-eight percent of these readmissions were related to complications or infections. From June 2004 through August 2009, 1,791 events of readmission to the emergency department within 48 hours were reported to the Pennsylvania Patient Safety Authority, 8% of which were Serious Events (indicating harm to the patient). In June 2008, the Medicare Payment Advisory Commission calculated the annual cost of readmissions to the Medicare program at $15 billion. The Obama administration's 2010 budget aims to reduce Medicare readmissions in order to fund healthcare reform. The Centers for Medicare & Medicaid Services posts hospital readmission rates for three conditions on its Web site. National readmission rates show a wide variance across states as well as variance between facilities within the same state. This high variance rate suggests that significant financial savings could be realized if best practices for preventing unnecessary readmissions were adopted. This article reviews both national policy related to readmissions and best practices that could help hospitals reduce readmission rates while simultaneously improving patient-centered care and patient safety.
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