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The Relationship Between Hospital Admission Rates and Rehospitalizations

Regions of the United States where discharged hospital patients are readmitted at comparatively high rates are often the same regions where overall hospitalization rates are high, new Commonwealth Fund–supported research finds. The study, published in the New England Journal of Medicine (Dec. 15, 2011), finds that the high use of hospital services in these areas is the factor most closely linked to rehospitalization rates, a strong indication of broad, systemic problems within U.S. health care.

The study, conducted by Arnold Epstein, M.D., Ashish Jha, M.D., and John Orav, Ph.D., examined rehospitalization rates across the country for Medicare patients with congestive heart failure and pneumonia, while also looking at how other variables, such as overall hospitalization rates, differences in patients' coexisting conditions, quality of discharge planning, and the number of hospital beds and physicians, affected readmissions. Of all the potential causes for regional differences in readmission rates, overall hospital admission rates played the biggest role, accounting for 16 percent to 24 percent of the variation in cases of congestive heart failure and 11 percent to 20 percent for pneumonia cases. No other factor accounted for more than 6 percent of the variation.

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