JAMA Studies Hospital Readmissions; Hello Again, Doctor!

It seems that if you wind up in a hospital, there's a possibility you'll return for more care. A new study, published in the Journal of the American Medical Association, found that nearly 20 percent of patients that had been discharged returned within 30 days.

Lead by Anita A. Vashi, the researchers examined records collected between July 2008 and September 2009 that reported on over four million patients in California, Florida, and Nebraska. They found that 17.9 percent of hospitalizations resulted in at least one return visit by the patients within 30 days. In fact, 57.4 percent returned within the first 14 days.

Although scientists have studied readmissions before, this study takes into account something that most other research didn't: emergency room visits. In fact, 39.8 percent of the trips back to the hospital that the researchers studied were emergency room visits.

Vashi and colleagues found that the most likely cases to wind back up in the hospital were heart failure and shock, septicemia, stroke, and complicated hip and femoral procedures. The least like to wind up back in the hospital were those who had undergone vaginal childbirth, standard and complicated cesarean delivery, and appendectomy.

These studies can help assess the quality of care, and show work that needs to be done to offer coordinated follow-up care. Currently, there is little support when it comes to transferring a patient from the hospital to home, which could explain the large amount of readmissions.

Further issues will plague the readmission process, though. Large U.S. teaching hospitals, such as those affiliated with major universities, are more likely to be penalized under a U.S. program linking Medicare pay cuts to higher rates of readmission, according to Bloomberg.