By Francis Koster, Ed.D. 

These days, re-hospitalizations have gotten a lot of attention, as they're incredibly costly and far too common--especially for the fragile Medicare population.

However, a year-long study at the University of Minnesota suggests that a concentrated effort may be able to cut down on such rehospitalizations dramatically. Based in a Minneapolis nursing home, the initiative offers focused care by a team of U of Minnesota specialists to discharged patients.

The program, based in the Transitional Care Unit at Walker Methodist Care Center, is unique and may be the only one of its kind, officials say. It brings together a physician, a nurse practitioner, a pharmacist and sometimes a dentist from the U of M, with a special focus on the 75 percent of patients most at risk of being rehospitalized. The group works to avoid common rehospitalization triggers such as drug interactions and care lapses.

The result, to date, as been a 20 percent drop in the home's rehospitalization rate, to a rate 33 percent below the national average. The state-supported study concluded that if the program were in place at other short-stay centers focused on transitioning from hospital to home, annual savings could be $5 billion or more for Minnesota alone.

To learn more about the program to the StarTribune website

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