Patient Readmissions Are A Revolving Door For Residential Addiction Programs
One of the continuing problems with addiction treatment has been the growing numbers of addiction patients failing to complete residential care.
The problem is these same patients turn around and are re-admitted for care within 90 days for the same diagnosis. Even in cases where patients are discharged from services as “treatment complete”, they are often left with fragmented follow-up of care. Problems typically include infrequent referrals to After Care services, linkages to AA Sponsors, basic networking to jobs, sober living arrangements combined with poor clinician communications.
Research has shown of the “nine million hospitalizations of Medicare Patients per year[i], or almost one in five patients (20%) are readmitted within a month of discharge. And many more of these same patients return to the emergency room”[ii].
According to the Robert Wood Johnson Foundation, “many of these patient re-admissions are caused by inadequate discharge planning, poor care coordination between facilities and clinicians and the lack of longitudinal community based care.” There’s little question that the high numbers of patients leaving early “against medical advice” from residential treatment plays into the problem of expensive patient readmissions.
Also interesting, is that independent hospital research data suggests the best timing care coordination should be started even before the patient is fully ready for discharge since they and their families may not fully comprehend their role in successfully overcoming addictions.
Programs in this study simply do not have a clear perspective of the quality control problems leading to patient re-admissions.
[i] Klees BS, Wolfe CJ and Curtis CA. Brief Summaries of Medicare and Medicaid: Title XIX of the Social Security Act as of November 1, 2010. Baltimore, MD. Office of the Actuary at the Centers for Medicare & Medicaid Service, 2010, www.cms.gov/MedicareProgramRatesStats/downloads/MedicareMedicaidSummaries2010.pdf
Carlos T. Jackson, Troy K. Trygstad, Darren A. DeWalt and C. Annette DuBard:” Transitional Care Cut Hospital Readmissions for North Carolina Medicaid Patients with Complex Chronic Conditions”. Health Affairs, 32, no.8 (2013)1407-1415. http://content.healthaffairs.org/content/32/8/1407.full.html
[ii] Jencks SF, Williams MV and Coleman EA. “Re-hospitalizations among Patients in the Medicare Fee-For -Service Program.” New England Journal of Medicine, 360(14): 1418-1428, 2009.
