One in four heart failure patients on Medicare winds up back in the hospital a month after being discharged, U.S. researchers said on Tuesday in a finding that illustrates the need for financial incentives to keep them healthy.

The researchers said many heart failure patients leave the hospital without written instructions on diet, exercise and proper use of their medications - simple preventive steps that could keep them out from returning.

“Coming back and forth into the hospital isn’t good for patients and it isn’t good for the healthcare system,” Dr. Joseph Ross of Mount Sinai School of Medicine in New York, whose study appears in the journal Circulation, said in a statement.

An estimated 5.3 million Americans have heart failure, a chronic condition that will cost $34.8 billion this year in direct and indirect treatment costs, according to the American Heart Association.

Heart failure occurs when a heart weakened by disease can no longer pump blood effectively.

Ross and colleagues studied discharge records from patients on Medicare, the U.S. government’s health insurance program for the elderly, between 2004 and 2006 who had been hospitalized with heart failure.

They found that each year, about 23 percent of patients returned to the hospital within 30 days of being discharged.

“I was hoping for improvement and was disappointed to find that was not the case,” Ross said.

He said doctors in the United States currently are not paid to keep patients out of the hospital. Instead, they are paid for taking care of them when they are sick.

“If we want to deliver better care, this trend is what we need to address,” Ross said.

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* Patients on Medicare often back in 30 days

* Study shows why doctors need different pay system

CHICAGO (Reuters)