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Patients may think they understand everything doctors tell them when they are released from the hospital, but a new U.S. study summarized by Reuters Health found several gaps in what they remember and areas where instructions could be clearer. Out of nearly 400 patients discharged from a large academic medical center, 96 percent reported knowing why they had been hospitalized, but only about 60 percent could accurately describe their diagnoses, for instance. “Patients were very positive, but when we asked them about actual facts, they could not tell us,” said Dr. Leora Horwitz, the study’s lead author from the Yale School of Medicine in New Haven, Connecticut.

For the new study, Horwitz and her colleagues asked 395 people age 65 and older about their experience after being discharged from Yale-New Haven Hospital between May 2009 and April 2010. They compared those patients’ responses to what was written in their medical charts and the instructions they were given when they were released.

The majority received instructions that included easy-to-understand language about what symptoms to watch out for and advice about activities and diet, but about a quarter of the instructions used medical jargon to explain the patient’s medical condition. For example, instead of saying the person had a “heart attack,” the instructions used the technical term “myocardial infarction.” About 35 percent of patients had trouble explaining why they were in the hospital. What’s more, about half of the patients recalled their doctor having scheduled a follow up visit while the medical records showed only about 33 percent actually had one scheduled. Also, less than one third of patients reported being told while hospitalized about their upcoming discharge more than a day in advance. Two-thirds of patients did recall being asked whether they would have the support they needed at home after discharge.

Hospitals are currently looking at ways to reduce the number of people who have to come back for additional care – something the U.S. government and economists say can be prevented to reduce overall healthcare spending. For people on Medicare, the government-run health insurance program for the elderly and disabled, hospital readmissions increase spending by an estimated $26 billion per year, according to federal figures. About $17 billion of that is thought to be potentially preventable. Much focus has been put on hospitals following recommended medical guidelines to reduce readmissions, though there is also some attention toward making sure patients know what to do after they leave the hospital.