Planning Hospital Discharges Pays Off

The most recent issue of the Annals of Internal Medicine has a thoughtful study from Boston Medical Center showing patients who have a "discharge assistant" coordinate discharge instructions and receive a followup call from a pharmacist after discharge have a dramatically lower rate of emergency department visits and rehospitalizations over the 30 days after discharge.  It's a small study (under 400 patients), and it might not be replicable in different kinds of hospitals.  The average age was under 50, and nursing home and skilled nursing facility discharges were excluded I believe the researchers underestimated the cost of the incremental ambulatory visits - but the savings in hospitalizations in the intervention group were enormous
(Harvard Link) 

Here's a scary thought.  In Medicare, 18% of patients discharged from the hospital are readmitted within 30 days at a cost of $15 billion per year.  35% are readmitted within 90 days.   

So, while disease management programs (see last post) have not shown huge savings, there are some provider-based programs that can both improve quality of care AND decrease costs.