No one likes being admitted to the hospital, so when the discharge planner says that you’re good to go, there are usually cheers all around. But in the excitement of the moment, it is easy to forget to ask some very basic questions about your next steps.

This story, by My Medicare Matters team with the National Council on Aging, says hospitals now have an incentive to make sure that your transition home is safe and appropriate. There are financial penalties for hospitals who have more readmissions than expected in the first 30 days after a patient’s discharge. And they also try to track “frequent fliers” – individuals who are admitted multiple times within several months or a year.
Constant discharges and readmissions for the same problem indicate that something has gone wrong in terms of patient-provider communications. So what are some of the key things you need to know when you leave the hospital?

1. Make sure you understand your new medications

One of the most confusing things about even a short stay in the hospital is that you might leave with a whole new set of prescriptions. Because you are often dealing with a “hospitalist”– a physician who works for the medical center and specializes in hospitalized individuals–they may prefer different medications from the ones your primary care practitioner usually prescribes to you. You may even need brand new medications that didn’t exist before. Or a former medication may have been discontinued while you were hospitalized.

To help address some of these issues, be prepared to present a list of the medications you were taking when you were admitted. Then compare it to the list of prescriptions that the staff at the hospital sends you home with, and make sure to consider the following issues:

Are there differences in the two lists? Talk to your doctor about what medications from your old list should still be included on the new one.
Are the new meds to be taken forever or just until your follow-up appointment?
Do you have a way of filling your new prescriptions (i.e. some form of transportation, or setting up a home delivery system)?
Can you afford the new medications? Are they covered by your plan?

2. Get ready for your follow-up appointment

Often your discharge instructions recommend a follow-up visit with your primary care physician, or perhaps a specialist that was introduced to you at the hospital. It is important that you understand what the next steps are. Consider the following:

Has the hospital already made an appointment for you or should you call and make it yourself?
Do you have a way to get to the appointment? (i.e. are you well enough to drive yourself, or should you arrange for help from a friend or family member?)
If you are being asked to see a specialist, is that individual covered by your insurance?

3. Know the “red flags” for your condition

Make sure you fully understand why you were hospitalized in the first place, especially if you have been hospitalized for the same condition previously. Knowing the “red flags” for your condition allows you to be proactive in monitoring your progress and making the right call before a crisis occurs. Be sure to consider the following:

What was the reason you were admitted? What steps can you take to prevent a future visit to the hospital?
Are there measurable signs (like blood pressure, weight, temperature, etc) that you should be monitoring to watch for significant changes?
If you see a change, what should be the next steps? Do you call the physician’s office or immediately go to the emergency room?

The answers to these questions are crucial. And honesty is the best policy. If you aren’t going to follow the doctor’s instructions – for example, if you’re not going to get a prescription filled because you can’t afford it, or you’re scared to use an inhaler for the first time – tell them that. It may be that an alternative can be found, and they won’t offer other options unless you are honest about your concerns and limitations.

The bottom line? Make sure your treatment plan fits your needs, and that you are 100% clear on all of your next steps. Otherwise, you could be looking at many more hospital visits to come.