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Project RED: Are Hospitals Pushing to Discharge Patients Too Soon?

Project RED: Are Hospitals Pushing to Discharge Patients Too Soon?

There’s an emerging new motto for hospital stays in the health care industry, and it doesn’t sound very nurturing: keep your stay short and once you leave, don’t come back.

According to the U.S. Department of Health and Human Services, Agency for Health Care Research and Quality, 1 out of every 10 hospital care dollars is spent on patients being re-admitted for unexpected problems after discharge. The problem is a particular concern for the elderly medicare patients who are being released after shorter hospital stays and in more fragile states.

According to the Wall Street Journal, the federal government is trying to cut that hospitalization spending by instituting a Boston University pilot discharge program called Project RED (Re-Engineered Discharge), which teaches hospitals to start planning for a patient’s departure the moment he or she checks in:

“With one in five of its elderly hospital patients re-admitted within a month of discharge, the federal Medicare program plans next year to reduce how much it will pay hospitals for certain preventable re-admissions. In April, Medicare announced it will provide $500 million in grants for organizations that work with hospitals on programs to reduce re-admissions. The government is funding an effort to help hospitals adopt Project RED, a discharge-planning program developed by Boston University that helped cut re-admissions at Boston University Medical Center by 30% in a 2008 study. Researchers there have developed the ‘virtual discharge advocate,’ Louise, to help explain home care to patients.”

The Medicare data ranks the top 5 re-admission prone medical conditions:

  • Heart attack: 19.9%
  • Heart failure: 24.7%
  • Pneumonia 18.3%
  • Circulatory system disorders: 10.4%
  • Mental health: 11.8%
  • Digestive disorders: 10.3%
  • Alcohol/substance abuse: 13.0%

While the federal government and Project RED developers praise the program’s focus on better preparing a patient for post-hospitalization self-care, concerns remain that medicare patients with serious medical disorders are possibly being pushed out of their hospital beds too soon in order to curtail costs. 

Advocacy groups such as the National Medicare Advocates Alliance and California Advocates for Nursing Home Reform have argued that a trend of premature discharge of elderly and severely ill medicare patients may be the real underlying problem of high hospital re-admission rates.

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Photo credit: Wikimedia Commons

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58 comments

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2:29PM PDT on Oct 13, 2011

It's been this way for as long as I can remember and it really angers me, especially when childbirth is concerned...and can somebody tell me what happened to bedside manner???

6:39AM PDT on Jun 15, 2011

Hospital beds keep filling up with return customers....

8:44PM PDT on Jun 13, 2011

The technical term is "turn and burn."

1:28PM PDT on Jun 13, 2011

Are we changing for the better or worse? Will we lose confident in our health care providers when we need it the most? In life or death situations? Where will we be able to turn to for help?

6:03AM PDT on Jun 13, 2011

As lee e said, this is nothing new. People are not only returning to the hospital just after being discharged but people are dying every day due to this managed health care way of doing things. I have returned to the hospital within 24 hours 3 times within the last 5 years...the last time because I was unable to swallow when discharged and almost choked to death...and all 3 times because of complications CAUSED by the hospitalization itself. BUT! I was discharged on schedule and was re-admitted under another diagnosis...so everything looked just fine on paper and that is all that matters. By the way, I am a nurse and have been watching caring for patients becoming nothing more than a business for years. I no longer work in that atmosphere...I would rather stock shelves in a store or babysit for a fraction of the pay. I just can't and won't be part of it anymore. Believe me...what you don't know can certainly kill you...but it won't be ME wearing the scrubs ever again.

7:58PM PDT on Jun 12, 2011

I think they keep them too long.

A visiting nurse and on call would be more cost efficient.

4:28PM PDT on Jun 12, 2011

"the federal Medicare program plans next year to reduce how much it will pay hospitals for certain preventable re-admissions"

Assuming there still IS such a thing as Medicare by next year.....

2:25PM PDT on Jun 12, 2011

Thank you.

8:48AM PDT on Jun 12, 2011

Husband was discharged from hospital Wednesday went back in on Thursday. Do you think someone was in a hurry to get him out?

10:09PM PDT on Jun 11, 2011

Not fair to kick someone out of the hospital if they are not ready- but knowing about all the horrible infections that you can get from bacteria in hospitals- I would RUN out of the hospital first chance I got!

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