The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.
Everyone expected 2013 would be a year of unparalleled change for healthcare, and it certainly hasn't let us down. But as usual, some of the most important stories didn't make the headlines. Or if they did, journalists didn't necessary grasp the full implications.
It's too bad, because, these unsung regulatory decisions, business transactions and ballot initiatives might have a huge impact healthcare in the future. In no particular order, here are five acute care stories of 2013 whose impact will likely be felt for years to come.
Rehospitalization Rates Fell In Conjunction with Medicare Penalties
"During the first eight months of this year, fewer than 18 percent of Medicare patients ended up back in the hospital within a month of discharge, the lowest rate in years, the federal government reported." The decline in the number of rehospitalizations occurred as Medicare began penalizing hospitals for high readmission rates. Although many in the medical community were skeptical of the effectiveness of such penalties, Medicare has touted the fact that "three out of every four local hospital markets experienced a decrease in readmission rates of a half-percent or more" as a result of the new penalty structure.
It's Saturday at 6 p.m., and the emergency department (ED) is running at full tilt. An elderly patient comes in complaining that he's felt weak and dizzy for the past month. It's clear that he needs a workup. During registration, he mentions that he lives alone, doesn't drive and has a hard time getting to the grocery store and doctor's office.
Now, my instinct as an emergency physician is to rule out any potentially catastrophic conditions, order the initial set of labs and admit him as quickly as possible. After all, that's my job, right?
There's an urgent need today for better integration in healthcare. Unfortunately, training and practice haven't quite caught up with reality.
Suddenly we're asking hospitalists and ED physicians to team up in ways they never imagined. We're asking them to think with one mind and act as part of an integrated team when they've been conditioned from medical school to side with their respective specialty's interests and to view each other with suspicion.
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Congratulations on a job well done. Love your focus on the patient experience!