Could increased readmission be linked to increase General Practitioner visits?
The trial by Holland et al looking at home based medication review by
pharmacists as an admission avoidance scheme produced interesting results.
Not least the counterintuitive result that significatly higher rates
of hospital readmissions were found in the intervention group.
The authors suggest some explanations for this finding, may I suggest
another.
The increase in General Practioner visits to the intervention group
may have led to more readmissions. There was a visit rate ratio of 1.43
(1.14 to 1.80; p=0.002) in the intervention group when compaired to the
control group.
These extra visits seem to have been propted by the 2.58
recomendations or comments from pharmacisits to the General Practioner's
per patient visited.
The pharmacists may have been acting as a screening tool for unwell
patients who needed readmission.
It can be argued that there is always a proportion of patients
struggling on at home who if seen by a member of the primary health care
team action, including admission, would be considered to try to stabilise
their condition.
Competing interests:
None declared
Competing interests:
No competing interests
06 February 2005
Richard L Davies
General Practitioner
703 Leeds and Bradford Road, Stanningley, Pudsey, Leeds LS28 6PE
The trial by Holland et al looking at home based medication review by
pharmacists as an admission avoidance scheme produced interesting results.
Not least the counterintuitive result that significatly higher rates
of hospital readmissions were found in the intervention group.
The authors suggest some explanations for this finding, may I suggest
another.
The increase in General Practioner visits to the intervention group
may have led to more readmissions. There was a visit rate ratio of 1.43
(1.14 to 1.80; p=0.002) in the intervention group when compaired to the
control group.
These extra visits seem to have been propted by the 2.58
recomendations or comments from pharmacisits to the General Practioner's
per patient visited.
The pharmacists may have been acting as a screening tool for unwell
patients who needed readmission.
It can be argued that there is always a proportion of patients
struggling on at home who if seen by a member of the primary health care
team action, including admission, would be considered to try to stabilise
their condition.
Competing interests:
None declared
Competing interests: No competing interests