Accident-related hospitalizations associated with advanced care patient sensitive matters (acute hospitalizations for acute respiratory illness and respiratory disorders) represent a direct measure of access to specialty care and the ability of the system to handle chronic problems like COPD, diabetes, congestive heart disease, chronic lung disease and asthma. The increasing complexities of medical problems and sudden unexpected changes in medical history and symptoms present challenges in the ability of the health care system to provide quality patient care. These health issues are typically associated with advanced procedures that require specialized equipment and skilled personnel who may not be always available on call. It has been found that although physicians and nurses are fully trained and capable of providing basic services, there are often limitations in the availability of staff and time to perform the necessary tasks during times of acute crisis.
Acute hospitalizations often occur in situations where other medical services have failed and urgent care or hospitalization is needed to prevent serious complications. In these cases, urgent care may reduce the length of time to recover but may cause more harm in terms of both financial and emotional burden on the family and individual. Many people living with chronic illness or with a pre-existing condition are often forced to make choices regarding lifestyle and employment that may severely impact their recovery. While they may be eligible for coverage under their primary policy or the short-term Medicare Part B, they may find themselves unable to make the full claims due to lack of suitable coverage or affordability of services.
This can include both hospitalizations for acute care and rehabilitation services. As described above, many people living with chronic illness are unable to make the full claims for Medicare. While this can be considered a setback, it should be understood that the government’s Medicare Modernization Act attempts to address this problem by encouraging timely hospitalizations and nursing home admissions for those requiring specialized medical care. While this may seem ironic given the focus of the act, ACSC recognizes that the increased need for hospitalization and nursing home admissions in order to prevent chronic illness is a real and growing challenge that is not likely to be addressed overnight. While it will take time, changes in the health care system will undoubtedly continue to reduce the number of people requiring admissions for rehabilitation services.
There are several ways that a physician level service plan can help to mitigate the risk of avoidable hospitalization. First, physicians can make a point of noting the patient’s eligibility for hospitalization as soon as they notice the potential need for such care. Second, physicians can implement a coordinated care strategy that provides all of the necessary information and tools to patients in order to facilitate hospitalization without unnecessarily placing them at risk. Third, through a focused program to promote continuity in care, physicians and other healthcare leaders can work to promote continuity in treatment programs, ensuring that the same physicians are treating patients with similar diseases and other conditions.
Although these are important points of consideration, reducing the risk of ACSC hospitalizations requires additional measures. To reduce the potential for ACSC hospitalizations, physician staff should work to improve communication between the patient and his or her primary physician. This improves both the quality and length of hospital stays. Additionally, as research has shown, improved collaboration between primary and specialty doctors may reduce the rates of missed hospitalization days and preventable adverse health outcomes. In addition, researchers have found that when healthcare providers work together in teams, patient outcomes tend to improve and prevent adverse outcomes from occurring more often.
The future of healthcare looks promising for the many patients who are able to receive routine care as a result of improvements in primary care performance and community engagement efforts. However, as research continues to reveal new discoveries regarding the prevention of many potential diseases and conditions, the need for coordinated action across many healthcare systems becomes even more important. ACSCs can play an important role in this effort by making the process of hospital admissions and outpatient visits more efficient. As researchers continue to pursue their goal to reduce the rates of preventable adverse outcomes, every medical center should consider implementing and improving their ACSC hospital admissions and outpatient visits.