Differences Between Early and Late Readmissions Among Patients

Kelly L. Graham; Edward R. Marcantonio

doi:10.7326/L15-5149-2

Letters |20 October 2015

Differences Between Early and Late Readmissions Among Patients

Kelly L. Graham, MD, MPH; Edward R. Marcantonio, MD, SM

Article, Author, and Disclosure Information

IN RESPONSE:

We apologize if our text was unclear. When we stated that the cut point of 5 days used in our sensitivity analysis was “not substantially different,” we meant relative to the 7-day results, not that the results were no longer significant. In fact, we performed this sensitivity analysis specifically to determine whether our findings were robust enough to justify the specific cut point used. The results show that whether 5 or 7 (or, we suspect, 6 or 8) days is used as the cutoff, the message is still the same: Early readmissions differ from late readmissions.

There is no “actual science” on which to base our choice of which day to use for a cutoff, because this issue has not been studied. We based our decision on clinical judgment, expert opinion, and a close look at the distribution of our data by the day after discharge. We did not simply use comfortable numbers as you suggest. In Figure 2 of our article, it seems that the distribution changes somewhat regarding the number of readmissions on any given day approximately 7 to 8 days after discharge. We hope that this approach was adequate to design our outcome, for which essentially no data were available on which to base our decision.

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Letters |20 October 2015

Differences Between Early and Late Readmissions Among Patients

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Letters |20 October 2015

Differences Between Early and Late Readmissions Among Patients

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