Doctor’s Diary January 17, 2018: Readmission

(Snippets from the frontline)


If you are admitted, discharged, and return with the same diagnosis within 30 days, hospitals are penalized by Medicare for the readmission.

Nowadays, hospitals are known to give conveyor-belt service, so sending patients home early is a fear.  But withholding reimbursement has ramifications, and ultimately side effects from these decisions affects elder seniors.

Why should blame be placed on a hospital (or doctor) when after discharge a patient with congestive heart failure goes home and consumes a bag of salt-laden potato chips; a pneumonia patient doesn’t have money to pay for heat; or a heart attack victim can’t afford cholesterol-lowering medication?

To avoid penalty and statistical stigma, hospitals instead have created self-serving remedies including placing patients under “Observation Status” (with higher out-of-pocket costs), or treat them in-and-out of the emergency room without admission.

Solving readmission problems by improving communication, computer discharge planning, and in-home follow up could be more helpful.  Soon, doctors will face similar penalties, so as a consequence might be reluctant to admit any new Medicare patient.

Attempting to save money by withholding reimbursement has side-effects, and should not lead to patient suffering.

Gene Uzawa Dorio, M.D.


  • David Evans says:

    Ultimately patient care is predicated on funding. Trillions of dollars squandered on wars for Israel by AIPAC-controlled COngress should be spent on inhanced medical care and other social and infrastructure instead.

  • If this situation leads to patient-suffering, what are doctors’ options under federal law? Under state-law?

    Could this situation affect choice of state by doctors finishing residency? H

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