What good is it for a hospital patient to be discharged, only to return a short while later with the same problem … or even worse, die of it?

Unfortunately, this happens often. Does it say something about the quality of care at the hospitals involved? The federal government seems to think so. In 2012, it implemented a program to financially penalize hospitals with above average Medicare readmission rates for three common conditions: pneumonia, heart attack and heart failure.

That approach might have merit, but it’s important to consider other factors that could boost readmission or death. Study results published since 1980 show there are many. Researchers writing in the Journal of General Internal Medicine reviewed studies on patients hospitalized for heart failure or pneumonia.

The results were telling: Older age was linked with more readmission and death after discharge. Race was a factor, too. Non-whites with pneumonia had higher rates of both negative outcomes. Readmission rates were higher among minorities with heart failure, but death rates were not.

Some studies found that low socioeconomic status or home stability, living in a rural area, being unmarried or lacking social support were associated with higher readmission or death risks. The same was true for some patient behaviors, such as smoking, using cocaine, failing to follow doctors’ directions and skipping health care appointments.

Obviously, hospitals have no control over these factors. Some face them more frequently than others.

It remains to be seen whether the new penalties will improve care. But patients have power to improve their own odds.

If you’re battling any serious health issue, be sure to obey doctors’ orders, return for follow-up care, abstain from harmful substances and surround yourself with supportive people. Give yourself a fighting chance.