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High Rate of Rehospitalizations Costing Billions
Date:4/1/2009

are, said Jencks, is a health system built around what he called "silos" -- the hospital, the doctor's office, the nursing home -- resulting in poor transitions from one care setting to another.

In an accompanying editorial, Dr. Arnold M. Epstein of the Harvard School of Public Health in Boston, said that "providing appropriate incentives for hospitals and community providers to share accountability and provide efficient care will be no easy task."

But Jencks suggested that immediate action is imperative. "The evidence is that the system is not working right and it's costing us billions of dollars a year and it's causing a great deal of patient and family misery," he said, "and we need to get cracking on it."

More information

Medicare has a checklist of questions that patients and caregivers should ask before leaving the hospital.



SOURCES: Stephen F. Jencks, M.D., M.P.H., independent consultant, Baltimore; Amy Boutwell, M.D., M.P.P., general internist, Newton-Wellesley Hospital, Newton, Mass., content director, Institute for Healthcare Improvement, and director, IHI's reducing rehospitalizations initiative, Cambridge, Mass.; Budget of the United States Government, Fiscal Year 2010, Office of Management and Budget, Washington, D.C.; April 2, 2009, New England Journal of Medicine


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