Opportunities and Challenges for Reducing Hospital Revisits
Authors: Kelly L. Graham, Michael D. Howell, Edward R. Marcantonio
Journal: Annals of Internal Medicine (2015)

Letters3 November 2015Opportunities and Challenges for Reducing Hospital RevisitsKelly L. Graham, MD, MPH, Michael D. Howell, MD, MPH, and Edward R. Marcantonio, MD, SMKelly L. Graham, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, Michael D. Howell, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, and Edward R. Marcantonio, MD, SMFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5154 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We appreciate Dharmarajan and Krumholz's thought-provoking comments about our article and its implications for patients and hospitals. In response, we would like to emphasize a few points. For several years, investigators have criticized the 30-day window used to determine hospital readmissions penalties (1), suggesting that shorter windows reflect “more preventable” readmissions (2). Our approach was different. We have learned that, for many diseases, the causes of poor outcomes differ over time and that treatments correspondingly need to change over time. For example, early treatment of stroke differs profoundly from later treatment. Early causes of death from myocardial ...References1. Joynt KE, Jha AK. Thirty-day readmissions—truth and consequences. N Engl J Med. 2012;366:1366-9. [PMID: 22455752] doi:10.1056/NEJMp1201598 CrossrefMedlineGoogle Scholar2. van Walraven C, Jennings A, Taljaard M, Dhalla I, English S, Mulpuru S, et al. Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions. CMAJ. 2011;183:E1067-72. [PMID: 21859870] doi:10.1503/cmaj.110400 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Kelly L. Graham, MD, MPH; Michael D. Howell, MD, MPH; Edward R. Marcantonio, MD, SMAffiliations: From Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0425. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpportunities and Challenges for Reducing Hospital Revisits Kumar Dharmarajan and Harlan M. Krumholz Opportunities and Challenges for Reducing Hospital Revisits Kumar Dharmarajan and Harlan M. Krumholz Metrics 3 November 2015Volume 163, Issue 9Page: 727KeywordsDisclosureElectronic medical recordsHealth careHospitalizationsInpatientsIntensive care unitsMedical risk factorsMyocardial infarctionQuality improvementStroke ePublished: 3 November 2015 Issue Published: 3 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...