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What are the rates of readmission in the US

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f399 (Published 23 January 2013) Cite this as: BMJ 2013;346:f399

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Cutting hospital readmissions is a priority for policy makers in the US, and many hospitals are already being penalised for high rates of readmission following discharges for heart failure, myocardial infarction, or pneumonia.

In one study, a quarter of older adults admitted with heart failure were back in hospital less than a month after discharge (24.8% of 1 330 157), as were a fifth of those admitted for myocardial infarction (20% of 548 834) or pneumonia (18.3% of 1 168 624). They were readmitted with a broad range of diagnoses, often unrelated to their original admission.

A second team of researchers analysed more than five million discharges from hospitals in three US states. Just under a fifth of all discharged adults bounced back into some form of acute care within a month (17.9%, 95% CI 17.9% to 18.0%) Readmissions were common, but almost 40% of acute care encounters after discharge were “treat and release” visits to emergency departments. The researchers warn that incentive schemes targeting readmissions alone will miss a substantial proportion of the problem.

Quality improvement projects to streamline transitions, coordinate care, and help close this revolving door are already under way in some states, says a linked editorial (p 394).

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Cite this as: BMJ 2013;346:f399