In a recent article published on-line by BMJ Quality & Safety on 5th April 2016, Friebel & Steventon present a timely discussion on the role of financial penalties in preventing unnecessary re-admissions.
In both the US and England, there are policies in place that seek to provide a financial incentive for hospitals to prevent unnecessary re-admissions. While such means are not generally in place in Australia, it is certainly a subject of wide discussion.
Most would argue that it is better to keep people at home or in their community wherever possible, provided they receive good care and are safe. Financial penalties are presumably designed to drive better care while in hospital and after discharge. Rates do appear to have improved in jurisdictions where such measures are in place, but it is essential to be sure that effective and efficient services are in place to ensure hospital, discharge and home care are the best they can be. Also, we should consider that some hospitals may have a disproportionate number of patients who are prone to re-admission and may therefore be disproportionately penalised.
In all cases, financial tools, where they are used, must drive better and cost effective care outcome measures alongside the simple numbers of re-admissions.