Features April 2013 Issue

Reduce Your Odds of Hospital Readmission

New research shows heart patients are often admitted within 30 days of discharge for non-heart reasons.

If you’ve been hospitalized for heart failure, a heart attack or other cardiac problem, you’re usually given careful instructions about how to deal with the condition that landed you there originally. But all too often, heart patients wind up being readmitted within 30 days for causes unrelated to their original hospitalization and in many cases for reasons  that could be prevented.

Those are the findings of a study done of three million hospitalizations. The research, published in the Journal of the American Medical Association, found that the causes of hospital readmissions for heart patients included conditions such as gastrointestinal bleeding, chronic obstructive pulmonary disease (COPD) and septicemia, an infection related to bacteria in the blood.

“Readmissions are common after myocardial infarction, heart failure, and pneumonia especially in older patients,” says Cleveland Clinic cardiologist Umesh N. Khot, MD. “.The healthcare system is increasingly focused on these because they are very costly.”

Dr. Khot notes that hospitals and physicians are always seeking ways to reduce readmissions, but it remains a great challenge to find strategies that will make a profound difference.

“Some readmissions are preventable, but it is not known exactly which ones and how to identify these patients,” Dr. Khot says.

Medication adherence
What is clear, however, is that following your medication regimen upon discharge is vital. After an event such as a heart attack or an acute episode of heart failure, you’re likely to have changes in your medications. Keeping those changes straight and taking them as prescribed could help keep you from being readmitted.

“The most important thing patients can do to prevent readmission is to have clear understanding of the medicines they need to take and to make sure they take them,” Dr. Khot says. “One of the most common problems is patients not knowing what medicines to take or not taking them at all or correctly.”

And if you have any questions or concerns about your medications, don’t hesitate to ask your doctor or a nurse, or even a pharmacist. This also applies to questions you might have about matters such as driving, exercise and other activities. It’s better to ask and get the answer than guess and hope you’re right.

It’s also important to speak up about how you’re feeling while you’re still in the hospital. While some indicators, such as your blood pressure, can be measured, others can’t. If you’re feeling lightheaded or dizzy, for example, or you’re having trouble catching your breath, tell your doctor. Researchers noted that one way to help reduce hospital readmissions is to do a better job evaluating patients to make sure they’re ready to be discharged.

Other considerations
In addition to following your doctor’s advice on medications and sharing your symptoms and questions with your healthcare providers, you should also know what else is expected of you in the weeks and months ahead.

“Patients should know with whom and when they are going to follow up in the outpatient clinic,” Dr. Khot says.

Likewise, if you’ve been referred for cardiac rehabilitation, make sure you know where and when to attend, or how to make the arrangements once you’re home. Remember that cardiac rehabilitation saves lives, and includes valuable education about living with heart disease, as well as supervised exercise.

Staying out of the hospital isn’t always possible, but if you follow your doctor’s advice and make sure you get the answers to your questions you can at least reduce your odds of readmission.