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Rampant Rehospitalization Costs Medicare Big Bucks

High rehospitalization rates point to a lack of adequate follow-up care in the community

WEDNESDAY, April 1 (HealthDay News) -- Medicare fee-for-service patients in 2003-2004 were frequently rehospitalized, often within 30 days of initial discharge, at an estimated cost of $17.4 billion nationally in 2004, according to a report in the April 2 issue of the New England Journal of Medicine.

Stephen F. Jencks, M.D., a consultant from Baltimore, and colleagues from Northwestern University in Chicago and the University of Colorado at Denver, analyzed Medicare data for 11,855,702 beneficiaries in 2003-2004 who were rehospitalized at 30-day, 90-day and one-year intervals after initial discharge.

The researchers found that 19.6 percent of these beneficiaries were rehospitalized within 30 days of discharge, while 34 percent were back in the hospital within 90 days. Of patients discharged with a medical condition, 68.9 percent either died or were back in the hospital within a year; for those discharged after surgery, 53 percent either died or were rehospitalized during the same one-year period. Among those who were discharged with a medical condition, 50.2 percent did not see a physician in the community as evidenced by the lack of any Medicare claim, the report indicates.

"When the typical patient has almost two chances in three of being rehospitalized or of dying within a year after discharge, it is probably wiser to consider all Medicare patients as having a high risk of rehospitalization. For example, ensuring that a follow-up appointment with a physician is scheduled for every patient before he or she leaves the hospital is probably more efficient than trying to identify high-risk patients and arranging follow-up care just for them," the authors write.

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