According to a recent article out of the New York Times, shorter hospital stays are not because hospitalized patients are becoming younger and healthier. In fact, by and large, today’s patients are actually older and sicker. Rather, shorter hospital stays may be attributed to hospital financing.
According to the New York Times, in 1980 the average hospital stay in the United States was 7.3 days, while today it is closer to 4.5 days. One reason attributed to this change came in the early 1980s when Medicare stopped paying hospitals for their claimed costs and phased in a payment system. This “prospective payment system” pays a predetermined rate tied to each patient’s diagnosis and shifts the financial burden of a patient’s hospitalization from Medicare to the hospitals. As a result, hospitals are economizing and one way to do this is to get patients out of their hospitals, sooner.
Almost as soon as this “prospective payment system” started, experts raised concerns that it would lead to a higher rate of readmission. Meaning, patients discharged too quickly may be prone to complications, necessitating their return to the hospital. According to the New York Times, evidence backs this logic. And, with recent programs created by the federal government aimed to penalize hospitals for readmission rates, e.g., Medicare’s Hospital Readmissions Reduction Program, where hospitals lose up to 3 percent of their total Medicare payments for patients readmitted within 30 days of discharge, questions remain as to whether patients are getting the care they need.