Why are Boston hospital readmissions so high among older medicare eligible patients? That’s the million dollar question, but public health experts agree that for this rate to fall, more follow-up care is needed at home. It’s called a Revolving Door Syndrome.

The federal government reports that one out of every 5 medicare eligible patients is readmitted to the hospital with 30 days of release, especially after surgery.

Your aging parents’ release from the hospital should not be an occasion for their health care to fall apart, but sadly that’s exactly what happens to many Medicare patients when they get home. The elderly are especially vulnerable.  Medicare estimates that more than $17 billion is spent on avoidable hospital re-admissions.  The best intentions of doctors and nurses can be thwarted at home if no-one is there to follow up on healing and care.


Risk Factors for Boston Hospital Readmissions

These are the risk factors which make it especially critical for your aging parent to receive the best follow-up and home respite care possible starting the day they come home from the hospital.

  1. The patient has 5 or more chronic medical conditions, such as COPD, heart disease, diabetes, cancer, stroke, high blood pressure, malnutrition or depression.

  2. The patient is on 5 or more prescription medications, or is starting on a new medication known to cause side effects. Some older patients take 10 to 15 prescription medications per week, which has its own hazards. Medication that is not monitored and overseen by a primary care doctor leads to more Boston Hospital Readmissions.

  3. The patient suffers from mild to severe cognitive disorders such as Alzheimer’s, vascular dementia, or lifelong mental health issues.

  4. The patient is taking narcotics, anti-epileptic medication, or antidepressants.

  5. The patient lives alone and has limited social contact and limited or no home care.

  6. The patient was given incomplete discharge instructions, did not know what questions to ask about convalescing at home, or was given new care instructions they didn’t really understand.


map of USA 2009 readmissions | Boston hospital readmissions article

map courtesy: Robert Wood Johnson Foundation

Boston Hospital Readmissions Climbed Above National Average

Massachusetts has some of the highest 30-day Medicare readmission rates in the country, according to 2010 findings by the Dartmouth Institute For Health Policy and Clinical Practice.

While the U.S. average for elderly patient readmissions was 16.1 percent in 2009, Boston hospital readmissions grew even higher.  The rate for both Beth Israel Medical Center and Brigham and Women’s was 20 percent, meaning one in five older Medicare patients wound up back in the hospital within a month of discharge.  As a caregiver who knows these top risk factors, you can support your own spouse or parents’ post-hospital recovery.

You can help keep them home and avert distressing, avoidable trips back to the hospital.