The Coalition government is planning to not provide money to hospitals for treating a patient if they are readmitted with a problem related to the one they had on first admittance. They are claiming this is to stop hospitals discharging people too early.
Here’s figures from the BBC story linked below.
- Emergency readmissions 1998-99 – 359,719
- Emergency readmissions 2007-08 – 546,354.
- Readmissions as a percentage of all patient discharges 1998-99 – 8%
- Readmissions as a percentage of all patient discharges 2007-08 – 10.5%
- From these we can roughly work out total number of procedures done, 1998-99 -4,500,000
- Total number of procedures done, 2007-08 – 5,200,000
- Number of extra people readmitted, 2007-08 – 186, 635
- Number of extra procedures done, 2007-08 – roughly 700,000
And from that we can see that even if we grant the premise, there were 500,000 or so people who benefited without needing to check back in. That’s not nothing. (We also need context on why people are readmitted – how related does it need to be? Are the figures mainly due to individual things like MRSA? Is it all just demographics, e.g. if more procedures are being done on elderly patients you might expect more of them to need to come back. Better understanding of the importance of home care? But let’s move on.)
For super-duper double irony, Lansley also called for patients to be given more control over their healthcare. But, in order to avoid financial penalties, hospitals will strongly be against releasing patients when they want to go home (although I suppose there could be a disclaimer; but surely not even the Tories would refuse to pay for patients who release themselves) and/or readmitting patients until they have passed that 30-day waiting period.
There’s nothing wrong with wanting hospitals to not kick sick people out the door before they are ready. But the use of financial disincentives is not going to help. Getting people out of hospital and into home care in order to make space for new patients is also a good thing, and the measures proposed show no sign of taking that into account. This looks very much like being a way of cutting budgets – through financial penalties and just plain doing less – while claiming to have maintained the ringfencing. Especially since even before the Big Bad Labour got their way, 8% of procedures required readmissions and there was never a Golden Age of zero readmissions.
Look forward to schools being penalised for each pupil who doesn’t leave with 5 A*-Cs and each pupil who has taken advantage of Evil Labour Grade Inflation by leaving with 10 A*s.
(As an experiment, and following something I read on Rough Type, Nick Carr’s blog, on removing links from text, all links presented below)