A new study by the New England Journal of Medicine found that one in five hospitalized Medicare patients were readmitted within a month of discharge from the hospital and a third were readmitted within 90 days. The study points the finger of blame at poor discharge planning, outpatient care, and gaps in follow-up care as causes.

These disturbing readmission rates raise concerns about quality of hospital care, but also hospital discharge planning. We asked Dr. John Santa, director of our Health Ratings Center, for his expert assessment.  “Hospital discharge is a crucial moment in medical care, when many things can—and too often do—go wrong. When you’ve been seen by multiple providers, as most hospital patients are these days, or when your primary-care doctor isn’t closely involved in your hospital stay, good discharge instructions are even more important and more difficult to come by.” Dr. Santa advises taking matters into your own hands—or the hands of a trusted family member—when it’s time to plan your hospital discharge. “Health care has become a team sport, and more often than not, the patient has to be captain of the team.”

As discharge approaches, make sure you know:

• The potential complications to watch out for.
• The doctor you should call if problems or questions arise.
• Where you will go, who will assist you, and any modifications to your home you may need.
• If you’ll need help with bathing, changing bandages, or any other medical care.
• What additional tests or treatments you may need and who will perform them. Get a written copy of that information, even if the hospital says they will send it to your doctor.
• The drugs you’re going home with or are supposed to start taking, their purposes, and their potential side effects. Also ask if there are any drugs you should stop taking.

—Ginger Skinner

Download the Centers for Medicare and Medicaid Services hospital discharge checklist, print it out, and have it handy for your next hospital stay. Read our report on pitfalls of aggressive medical care, look up your hospital and see our tips for getting better hospital care.