USA: Program lowers senior rehospitization

BOSTON, Massachusetts / UPI / Health News / June 14, 2011

Researchers say a rehabilitation center in Boston is having success in keeping seniors from being rehospitalized following discharge.

There has been a significant increase in the number of seniors being discharged from skilled nursing facilities who wind up back in the hospital within 30 days, researchers at the Hebrew Rehabilitation Center, an affiliate of Harvard Medical School, say. The rehospitalization rate carries an annual cost of $17 billion, they say.

The center's Recuperative Services Unit, a skilled nursing facility, instituted intervention policies that include guidelines for common geriatric syndromes, medication reconciliation and goals for care.

The center's palliative care team also consulted with patients who had three or more hospitalizations in the past six months to determine whether re-hospitalization was consistent with the patient's goals of care, or if worsening symptoms would be managed best in a skilled nursing facility, in long-term care or at home.

The researchers compared patient discharge rates before and after implementation of the intervention practices.

The study, published in the Journal of the American Geriatrics Society, found the rate of patient re-hospitalization fell from 16.5 percent to 13.3 percent. Discharges to home increased from 68.6 percent to 73 percent and discharges to long-term care dropped to 11.5 percent from 13.8 percent, the study says.

"The change in discharge disposition observed between the two periods, we believe, reflects an improvement in patient outcomes," Dr. Randi E. Berkowitz, a geriatrician at Hebrew Rehabilitation Center and the study's lead author, says in a statement.

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