Hot Dogs Over Heart Disease: Berkshires Hospital Combats "Recidivism"

With health care reform looming, everyone's worried about how to cut costs. When everyone's insured, won't premiums go through the roof? One way to fight freaky fees is to keep patients out of the hospital once they've been in. The Berkshire Medical Center is trying exactly this in a program designed to cut down on hospital patient recidivism. Among the tips and tricks used are encouraging heart patients to avoid hot dogs, which are so full of sodium that they can promote fluid retention and trigger heart trouble. Staying frank-free is harder than you might think, though, especially around Independence Day: this July 4, one Berkshire Medical patient chowed down on a dog; she was back in the Center the next day.

The Medicare Payment Advisory Commission estimates that about 12 billion dollars go toward "potentially preventable" hospital visits annually; these visits often involve elderly patients on Medicare, up to 30% of whom are rehospitalized within 30 days of their initial stay. Berkshire Medical has tried a number of innovative techniques, from hot dog avoidance to a telephone system that monitors patients' vitals from home, alerting hospital staff when there are fluctuations in stats like weight and heart rate. The Center reports its own 30-day return visit rate has fallen below 20% in 2008, in part because of programs designed to target it.

Financially penalizing hospitals with high readmission rates is seen as one way to solve the recidivism problem—but will this just result in cash-strapped institutions being unable to serve sick people? Either way, you might want to rethink a frank next time you're at Fenway—especially if you've been hospitalized recently.