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Medicare Rehospitalization Data Highlight Importance of Postdischarge Care
Medicare patients' high rates of rehospitalization raise questions about the quality of the transition between hospital and ambulatory care in the U.S.
Researchers examined 15 months of claims data to determine rates of unplanned rehospitalizations among some 12 million Medicare beneficiaries. Two thirds were rehospitalized or died within a year of discharge; 90% of rehospitalizations were unplanned; and half of those rehospitalized within 30 days had no evidence of having seen a doctor between hospital episodes.
The study's authors, writing in the New England Journal of Medicine, offer one possible lesson of their analysis: "A safe transition ... requires care that centers on the patient and transcends organizational boundaries."
An editorialist calls readmission rates "a crude outcome" that "may sometimes represent more efficient care rather than premature discharge, inadequate handoffs, or poor quality ..." Nonetheless, he calls for shared incentives to create "better coordination of care between inpatient and outpatient domains."
LINK(S):
NEJM article (Free abstract; full text requires subscription)
NEJM editorial (Free)
Journal Watch Hospital Medicine summary (Free)
Published in Physician's First Watch April 2, 2009
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