Introduction
This paper is devoted to the possibilities of reducing the readmission rate through transitional care among Medicare patients with heart failure. The reduction might allow reducing the financing of the hospitalizations in particular, as well as overall expenses on healthcare. The previous three stages of the project have provided information on the possibilities of decreasing the readmission rate. This paper aims to describe Stage 4, which is expected to give an analysis of the collected data.
It is acknowledged that heart diseases are common. Besides, in the majority of healthcare systems, the financing of hospitals is a major item of expenses. Generally, it tends to comprise up to 50 percent of all the expenditures. Hence, take into account the fact that expenses on medical provision have been widely cut off, control of expenditures on the healthcare system entrains the necessity to work out means of improvement in the efficiency of hospitals. However, it does not appear to be easy. Nowadays, it is accepted that it is necessary to reduce the number of readmissions of patients with heart failure. To achieve this, different approaches are applied. Their effectiveness happens to the range. In some cases, the number of readmissions is aimed to be reduced directly by influencing patients. In other cases, doctors are supposed to reconsider their approach to work so as to reduce the necessity in readmission.
Strategies
There are several strategies of reduction in the number of readmissions of patients with heart failure, which can be successfully used. They are going to be analyzed below. First of all, it is necessary to dwell upon the reduction of the demand for readmissions from the patients’ side. In order to reduce the demand for readmissions of patients with heart failure, it is obviously necessary to decrease risks which are connected with them. Therefore, it is reasonable to create conditions that might allow improving patient’s health and making more thoughtful decisions from the patient’s side. These strategies might be considered as simple ones. However, when it comes to practice, they prove rather difficult to be accomplished. In spite of this, the problem appears to be possible to be solved positively (The Centers for Disease Control and Prevention, 2014).
There are three potentially effective ways to reduce the number of readmissions of patients with heart failure. The first one is the introduction of prevention programs. The second one is the implementation of the program of chronic disease control. The third one is a more active process of involvement of the patients into the treatment. Preventive programs happen to be the most effective from the financing point of view since they are focused on the people who have a risk of readmission. For example, it is possible to think of a program for the elderly with heart failure, which is aimed to prevent patients from falling as elderly people have fragile bones. When they fall, they may get a fracture, which entrains an inevitable hospitalization. In order to solve the problem, it is reasonable to work out a program which might teach elderly patients to keep the balance and control their blood pressure. In fact, this is a complex of exercises that are supposed to be done three times a week. If elderly people participate in the program while they are hospitalized, they have a possibility of increasing the possibility of a faster recovery and, thus, of reducing the chance of readmission. This program is not difficult to be fulfilled. It is considered to be a very successful program (McHugh & Ma, 2013).
As for the program of chronical heart diseases control, there is a simple principle in its basis: the more effective the treatment in hospital is, the less possible a readmission is. So, there should be a program which aims to increase the effectiveness of service for elderly people who suffer from chronical heart diseases. For example, there might be created a program for those who suffer from diabetes, which aims to substantially reduce any possible complexities and, thus, decrease the number of potential readmissions. In accordance with a preliminary estimation, this program might demonstrate a great efficiency. Successful programs are supposed to take into account any peculiarities of the patients, especially their age, as well as use the understandable methods of clinical diagnostics in order to determine the character and content of the aid which is requested. Besides, it is necessary to approve of various ways to stimulate patients and doctors and guarantee their effective cooperation to arrive at a high result. It is necessary to note that programs which are aimed to control chronical heart diseases require substantial investment.
However, once the program is operational and readmissions are reduced, healthcare expenses on elderly patients with heart diseases appear to be cut down. Apart from that, programs of control of chronical heart diseases encourage patients to take an active part in the process of treatment. However, in order to achieve a reduction in the number of readmissions by means of involving patients in the process, it is necessary to apply special methods. For example, some tests, such as blood pressure check, can be done at home. It is obvious that elderly people who have tests at home assume more responsibility for their health than those who address to any medical facility and get hospitalized for certain diagnostics. However, doing medical tests at home is more convenient for both patients and medical facilities. Moreover, it seems possible to assume that some of the procedures which are made at home allow achieving higher results than those which are made in hospital due to a calm atmosphere and psychological easiness (Franks, 2015).
Results
A more active involvement of patients in the process of treatment might assist in reducing the readmission rate only in case there are some alternative ways of treatment which are not worse than traditional ones or even better than they are. Besides, they are expected to be less expensive. In these situations, there are larger opportunities for a decrease in demand for readmission. It is important to help patients to make more thoughtful decisions. Any help in making decisions which provides elderly patients with exhaustive information about various methods of treatment of heart diseases might result in the reduction of readmission rate as well. This help might be represented in different forms. Particularly, it might be useful to give elderly patients special booklets, show topic videos, and provide them with recommendations what to do after they are released from the hospital. Besides, it might be helpful to create special online resources which will give patients a chance to get to know different ways of possible treatment of heart diseases with a possibility to communicate with a doctor or nurse to get a consultancy (Verhaegh, 2014).
What is more, changing doctor’s behavior is critical. Another way to reduce the number of readmissions is not to provide patients with excessive medical services, including readmission of those patients who do not need any readmission. In some case, it might be wise to adjust methods of encouragement of doctors in the healthcare system so as to avoid any situations when there is a stimulus to provide more healthcare than the patient really needs to be based on his condition. At the same time, if doctors are encouraged to change usual methods of work and supported to use additional possibilities to increase the efficiency of the initial admission. Doctors tend to direct many elderly patients with heart diseases to readmission because they do not have enough experience in the treatment of such cases of these diseases. Besides, they are not aware of alternative methods of treatment and have to face their own incapability of providing the patient with necessary help. In spite of the above-said, it is necessary to realize that it is unlikely to be possible to reduce the number of readmissions substantially, as some patients could really need a follow-up hospitalization. However, it may be wise to persuade doctors who tend to address patients to readmission not to do it if there is no real need. Besides, there are some illnesses which can be treated at home. However, they need medical supervision which does not involve hospitalization (Zamanzadeh, V., Valizadeh, L., Tabrizi, F., Behshid, M., & Lotfi, M., 2015).
Conclusion
In conclusion, it is necessary to state that any reductions in readmissions tend to evoke a lot of argument. In order to achieve the goal, it is necessary to have an elaborated plan, as well as a strategy, which helps to avoid any dangers for the society and medical specialists. It is important to understand that instead of readmission of elderly patients, some alternative help measures should be suggested.
References
The Centers for Disease Control and Prevention. (2014). Planning, implementing, and evaluating an intervention: An overview. Web.
Franks, S. (2015). Transitional care to reduce 30-day heart failure readmissions among the long-term care elderly population. Web.
McHugh, M., & Ma, C. (2013). Hospital nursing and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. Med Care, 51(1), 52-59.
Verhaegh, K., MacNeil-Vroomen, J., Eslami, S., Geerlings, S., de Rooij, S., & Buurman, B. (2014). Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health Affairs, 33(9), 1531-1539.
Zamanzadeh, V., Valizadeh, L., Tabrizi, F., Behshid, M., & Lotfi, M. (2015). Challenges associated with the implementation of the nursing process: A systematic review. Iranian Journal of Nursing and Midwifery Research, 20(4), 411-419.