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4 November, 2019 00:00 00 AM
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Understanding hospital discharge instructions

Understanding hospital 
discharge instructions

The rate of hospital readmissions for seniors with infections that were first treated during their initial hospital stay is too high, researchers report. "We found that as many as 5 per cent of patients leaving the hospital with an infection have a readmission for that pre-existing infection -- that's bad," said Geoffrey Hoffman, an assistant professor in the University of Michigan's School of Nursing, in Ann Arbor. Hoffman led a team that analysed Medicare data on more than 318,000 hospital discharges for patients aged 65 and older. Overall, 2.5 per cent of them were readmitted for a pre-existing infection.

The most common type of pre-existing infection in the patients was C. difficile (about a 5 per cent readmission rate) -- which causes diarrhoea and colitis, and is potentially deadly -- followed by urinary tract infections (2.4 per cent readmission rate).

While it may seem small, the overall 2.5 per cent readmission rate for pre-existing infections is too high when you consider that hospitals know how to treat these infections and knew patients had the infections at discharge, Hoffman explained.

"Presumably they've been treated for the infection since the hospital has already billed Medicare," he said in a university news release. "Readmissions shouldn't be zero, but they should be much closer to zero."

The researchers were surprised to find that patients discharged to home care (with home care provided by an agency) or discharged home (without home health care) were 38 per cent more likely to return with a linked infection than those discharged to skilled nursing facilities. "This is somewhat conflated with the conventional wisdom, which is that skilled nursing facilities are warehouses for infection transmission," Hoffman said.

However, while infections spread at high rates in skilled nursing homes, they're also adept at treating them, according to the researchers.

"There are probably some gaps in self-care for patients going home with an infection from the hospital," Hoffman said. "This suggests home health care agencies aren't up to snuff with infection control, and patients going home without home health care probably need better training, as do their

caregivers."

Of the patients in the study, 50 per cent were discharged to a skilled nursing facility, 26 per cent to home health care and 24 per cent to home.

The study was published online Oct. 23 in the Journal of the American Geriatrics Society.

To reduce the risk of hospital readmission, patients and family members should keep asking questions until they fully understand discharge instructions, Hoffman advised.

 HealthDay

 

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Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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