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Study: Medicare Patients With Dementia 20% More Likely to Be Readmitted

Authors see dementia as marker for rapid rehospitalization

A review of more than 25,000 admissions of Medicare beneficiaries to Rhode Island hospitals has found that patients with a documented diagnosis of dementia are nearly 20% more likely to be readmitted within 30 days than are those without dementia. The study, by researchers at Rhode Island Hospital, was published online in the Archives of Gerontology and Geriatrics.

In 2010, the Patient Protection and Affordable Care Act imposed penalties related to hospital readmission rates. The initial phase went into effect in October 2012 and reduced Medicare payments for readmissions within 30 days of discharge related to three common hospital discharge diagnoses: acute myocardial infarction (heart attack), pneumonia, and congestive heart failure. Penalties will increase and the list of conditions will expand in fiscal year 2015.

“Our results indicate that a diagnosis of dementia may be a marker of vulnerability for rapid rehospitalization and may suggest a role for specialized initiatives aimed at lowering readmission rates,” said principal investigator Lori Daiello, PharmD. “Developing effective interventions to prevent unnecessary readmissions is critically important because hospitalizations are often destabilizing events for persons with dementia and consequently place undue burden on our patients, their families and caregivers, and ultimately on our health care systems due to financial penalties and reduced Medicare reimbursements.”

Successful transitions from hospital to home often require that patients be involved in complex decision-making, altering medication regimens and adjusting familiar routines. Negotiating this path is challenging, even for cognitively intact adults. Patients with dementia may be unable to accomplish some or all of these tasks successfully, and yet little is known about the impact of dementia on transitions from hospital to home, Daiello said.

Source: Rhode Island Hospital; April 29, 2014.

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