Lewis G. Sandy, MD, MBA
Disclaimer: Comments are personal opinions of the author and not the opinions or position of UnitedHealth Group or affiliated companies.
Potential Conflicts of Interest: Dr. Sandy is an employee of UnitedHealth Group with stock/stock options.
Sandy LG. Reducing 30-Day Rehospitalization. Ann Intern Med. 2012;156:251. doi: 10.7326/0003-4819-156-3-201202070-00025
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Published: Ann Intern Med. 2012;156(3):251.
TO THE EDITOR:
Although Hansen and colleagues should be commended for compiling a well-written, thorough, and timely review (1), the final paragraph (particularly the last sentence) made me wince, raising a larger point about the evidence base—and sources of evidence needed—for system improvement and policy.
In contrast to the published literature, my observation of hospitals and hospital systems that undertake work in this area is that they generally improve readmission rates, especially if they are focused, supported in their improvement efforts, and incentivized to do so.
Well-studied interventions are mentioned in the article. The Society For Hospital Medicine and the Institute for Healthcare Improvement, among others, have robust initiatives in this area. Our benefits company (UnitedHealthcare) has been successful in reducing hospital readmissions through combined in-market and telephone inpatient care advocacy and transition management and engaging with facilities, and high-performing ambulatory care systems are quite adept at reducing readmissions, again if there are incentives to do so. Hospitals that seek to improve in this area have many resources to draw upon.
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