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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