Reasons for and Timing of Readmission for Older Patients Following Hospitalization for Heart Attack, Heart Failure, or Pneumonia

INTRO: Heart attack, heart failure and pneumonia are three common conditions that often lead to hospitalizations for older patients. But what happens to these patients after they are treated for the initial problem and are discharged from the hospital? A new study examined frequency, reasons for, and timing of re-hospitalization occurring within 30 days of hospital discharge. Catherine Dolf has more in this week’s JAMA Report.

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Patient on gurney video freeze and blurs, graphic- 3 illnesses wipe in:
Heart Attack
Hearth Failure
Pneumonia, graphic out video resumes

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THREE COMMON ILLNESSES SENDING MANY OLDER PATIENTS TO THE HOSPITAL ARE HEART ATTACK, HEART FAILURE AND PNEUMONIA. ONE IN FIVE OF THESE PATIENTS END UP BEING READMITTED TO THE HOSPITAL WITHIN 30 DAYS AFTER THEY LEAVE.

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SOT/FULL Super @:11 Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine Runs:08
“The period after people leave the hospital is a very high risk period and there’s increasing attention about how we can make this a safer time for people.”

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SOT/FULL Super @:18 Kumar Dharmarajan, M.D., M.B.A., – Yale New Haven Hospital Runs:09
“Even though they may make it through the initial hospitalization they remain at elevated risk for a broad range of new medical problems.”

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Dr. Krumholz and Dr. Dharmarajan walking down the hall, sitting at table with another colleague, ambulance arriving, Dr. Dharmarajan looking at monitor, cu of monitor, various shots of heart procedure being conducted, patient having temperature taken

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DR. HARLAN KRUMHOLZ AND DR. KUMAR DHARMARAJAN (Dar-mah-RAH-jahn) FROM THE CENTER FOR OUTCOMES, RESEARCH AND EVALUATION AT YALE NEW HAVEN HOSPITAL AND CO-AUTHORS STUDIED MEDICARE FEE- FOR-SERVICE BENEFICIARIES ADMITTED TO THE HOSPITAL WITH THESE THREE COMMON ILLNESSES FROM 2007 TO 2009. RESEARCHERS STUDIED WHAT HAPPENED TO PATIENTS DURING THE FIRST 30 DAYS AFTER DISCHARGE, HOW SOON THEY WERE READMITTED, THE REASON FOR REHOSPITALIZATION AND WHETHER RACE, SEX OR ETHNICITY WERE ASSOCIATED WITH WHEN AND WHY THEY WERE READMITTED.

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SOT/FULL Super @:54 Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine Runs:17
“Two thirds of all those hospitalizations occurred in that early two weeks and the earlier the higher the risk. People remained at high risk throughout the month so despite the fact that the highest risk was early they still were in pretty high risk even two, three or four weeks after leaving the hospital.”

(Video covering middle of bite: patient being wheeled on a gurney)

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SOT/FULL Super @1:11 Kumar Dharmarajan, M.D., M.B.A., – Yale New Haven Hospital Runs:09
“If they had a heart attack they may be at risk for things besides a heart attack after hospitalization such as bleeding, or an infection or a fall.”

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GXF FULL JAMA COVER

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THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

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SOT/FULL Super @1:25 Kumar Dharmarajan, M.D., M.B.A., – Yale New Haven Hospital Runs:10
“Whether they were older, younger, whether they were a different racial, ethnic group, a man or a woman, they were coming back in with the same conditions to a large degree.”

(Video covering middle of bite: Dr. Dharmarajan walking in hospital)

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Patient in wheel chair going down the hall

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RESEARCHERS SAY PATIENTS DISCHARGED FROM THE HOSPITAL ARE JUST ENTERING A SECOND PHASE OF THEIR ILLNESS.

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SOT/FULL Super @1:40 Harlan M. Krumholz, M.D., S.M., – Yale University School of Medicine Runs:14
“You’ve finished phase one of care but phase two is getting better, recovery, convalescence and that is probably going to take active intervention. We need to provide support for patients as they get better, stronger, healthier probably over the whole month after they leave the hospital.”

(Video covering middle of bite: nurses looking at computer)

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Gurney being wheeled out the door

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CATHERINE DOLF, THE JAMA REPORT.

TAG: RESEARCHERS SAYS HOSPITALS THAT WERE LEAST LIKELY TO PROVIDE OUTPATIENT FOLLOW-UP WITHIN SEVEN DAYS AFTER HOSPITALIZATION FOR HEART FAILURE HAD THE HIGHEST RATES OF READMISSIONS WITHIN THE FIRST 30 DAYS.