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practices, will yield significant savings to the state and improve patient outcomes.


The main issue in the readmissions lies not in procedural errors but rather in fully resolving the initial medical complaint and creating an effective transition from the hospital to care in the community or a post-acute facility.


Potentially preventable hospitalization conditions include bacterial pneumonia, dehydration, urinary tract infections, congestive heart failure, hypertension, asthma, chronic obstructive pulmonary disease, and complications from diabetes.


Readmission is also more prevalent if the patient has a mental health or substance use disorder. Of the top four Medicaid diagnostic codes for both 2009 and 2010, mental health conditions accounted for the highest number of potentially preventable readmissions.33


DSHS received $2 million from the Texas Legislature in 2011 to design strategies to reduce potentially preventable hospitalizations. DSHS contracted with 16 Texas counties to reduce hospitalizations and/or hospital charges for adult potentially preventable hospitalizations. DSHS already has demonstrated via interventions in Red River, Freestone, and Limestone counties that we can reduce the incidence of hospitalization for certain conditions.


Our state clearly struggles with certain disease conditions. Particular portions of the state clearly struggle more than others. Potentially preventable hospitalizations are a burden to patients and their


September 2012 TEXAS MEDICINE 69 A PHYSICIAN’S STORY


Hector Trevino, MD Eagle Pass


Patients Come First


“You’re supposed to put God first, family second, your nation, and other things. And as a doctor, you put patients first, and then everything else comes after that.”


physicians, facilities, insurers, and taxpayers. This is not solely a government problem, but because of the enormous cost of potentially preventable hospitalizations and their impact on public and private payers, we need a community response.


Invest in mental health and substance abuse community treatment


Mental illness and substance abuse hurt the Texas economy through lost earning potential, treatment of coexisting conditions, disability payments, homelessness, and incarceration.


Mental illness is a leading cause of disability in the United States. About 13 million adults have a


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