Patients may need better info when leaving hospitals

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Older patients may think they understand everything doctors tell them when they are released from the hospital, but a new U.S. study found several gaps in what they remember and areas where instructions could be clearer.

 The study surveyed almost 400 patients after being discharged from the hospital and found that 96 percent thought they understood why they’d been in the hospital. Just 60 percent, however, correctly identified their diagnosis.

Dr. Leora Horwitz, professor at the Yale School of Medicine in New Haven, Connecticut and the study’s lead author said, œPatients were very positive, but when we asked them about actual facts, they could not tell us. This is worrisome because people who don’t understand their diagnosis are more likely to be readmitted to the hospital at a later date. They might not understand the severity of their disorder or misunderstand the best way to treat it, thus leading to more complications and higher medical costs. Economists say that if this problem is remedied, it will help the country reduce its overall spending on health care.

In the study, 395 patients age 65 and older were interviewed about their experience with the doctor. The researchers were concerned with how effective hospital discharge procedures are. Most of the time, doctors were careful to explain in layman’s terms, but about a quarter of the patients’ instructions contained medical jargon. Instead of saying œheart attack, for instance, a doctor would say œmyocardial infarction.

To remedy this problem, Dr. Karin Rhodes, director of the Center for Emergency Care Policiy and Research at the University of Pennsylania’s School of Medicine, suggested medical centers create teams who would specifically handle discharges.  Also, researchers suggested that hospitals use teach-back methods, which would make a patient explain the instructions back to their care provider to make sure the patient understands what was said.  Patients would be taught to ask their doctors three questions at discharge: What is my main problem? What do I need to do? Why is it important for me to do this? Another beneficial tool for patients would be to write down questions as they occur to them and make sure their doctors answer each one before leaving the room.
Regardless, we need to make sure our physicians are focused on the patients and not just focused on meeting regulatory benchmarks.

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