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Higher Hospital Admissions Equal Higher Readmissions: Study
Date:12/15/2011

By Maureen Salamon
HealthDay Reporter

WEDNESDAY, Dec. 14 (HealthDay News) -- Efforts to reduce costly hospital readmissions have focused on improving patient care just after discharge. But much of the readmission problem may be due to an overuse of inpatient hospital services in the first place, a new study suggests.

Researchers from the Harvard School of Public Health found that overall hospital admission rates played the biggest role in readmission rates among Medicare patients from various geographic regions, accounting for up to 24 percent of the variation in readmission totals among those with congestive heart failure and up to 20 percent among those with pneumonia.

Unplanned readmissions -- especially for such potentially serious conditions -- are often linked with poor health results, the study noted. But prior research has shown that attempts to improve hospital discharge planning haven't made a significant dent in readmission rates.

"This is about more than just how we discharge patients and follow-up, but about what happens to patients before they get admitted to hospitals," said Dr. Bradley Sherman, chairman of the department of medicine at Glen Cove Hospital in Glen Cove, N.Y., who was not involved with the study. "I think the interesting part of this article is there is so much effort put on the discharge process, but this falls in the gap. Not a lot of people are looking at the other side of this, how the admission process affects readmission rates."

The report is published in the Dec. 15 issue of the New England Journal of Medicine.

For the study, Dr. Arnold Epstein and colleagues used national Medicare data from the first six months of 2008 to calculate the 30-day, 60-day and 90-day readmission rates for patients discharged with congestive heart failure or pneumonia in different U.S. regions. Examining overall hospital rates along with differences in patients' co-existing condi
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