04/01/2025
I’ve been thinking a lot about how we care for our elderly loved ones after a hospital stay. A year few years ago, my grandfather passed away after being discharged from the hospital too soon. He was sent to a rehab facility, but they didn’t even check his basic labs. He got worse quickly, and by the time anyone realized, it was too late.
My wife’s grandmother had a similar experience. She went to rehab after a hospital stay, but the care just wasn’t there. She didn’t survive either.
And not long ago, one of my patients — a 93-year-old — also passed away in rehab. Same story: early discharge, not enough medical oversight.
But recently, my 89-year-old grandmother got very sick with diverticulitis. Remembering what happened before, I did everything I could to care for her at home and keep her out of rehab. With good outpatient support, she got better — and she’s doing great today.
It made me realize: my grandfather, my wife’s grandmother, and even that patient might still be here if they had gotten the same chance.
The truth is, hospitals often feel pressure to send patients home early because of Medicare’s payment system. Instead of being paid for the time and care someone needs, hospitals get a set amount of money based on the diagnosis. That leads to quick discharges — even when someone isn’t ready.
And research backs this up:
Hospitals sometimes time discharges based on money, not medicine (Eliason et al., American Economic Review, 2018)
Shorter hospital stays can hurt patients and increase readmissions (Pott et al., Social Science & Medicine, 2023)
Medicare’s copays for rehab lead to shorter stays and worse outcomes (Werner et al., Health Services Research, 2019)
Pushing early discharges increases readmissions and the need for more care later (Regenbogen et al., JAMA Surgery, 2017)
We need to rethink how we care for older adults. They deserve time to heal — not a system focused on saving money over saving lives.
