Hospital re-admissions are hitting Medicare patients particularly hard.

Otherwise known as “bouncebacks,” MedPage Today reports on a recent NEJM study showing that, during a 15-month period, 20 percent of hospitalized Medicare patients were re-admitted with 30 days of discharge.

When you consider how few outpatient doctors accept Medicare, compounded by the appointment shortage that many primary care physicians face, it’s no wonder that these elderly patients who are discharged from the hospital rarely have appropriate followup.

As the author of the study wryly notes, “It’s pretty clear that simply giving patients a phone number to call for a follow-up appointment is not enough.”

Two solutions proposed use the stick approach, namely, financial penalties for high re-admission rates, and publicizing those numbers to the public.

Of course, that really circumvents the real issue, which is the lack of primary care doctors who take new Medicare patients, and of those that do, the need to improve their appointment availability.