Preventing re-admission: Are general practitioners the solution?

Abstract

In the United States the Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions [ [1] Centers for Medicare and Medicaid Services. Value based programs. Hospital Readmissions Reduction Program (HRRP). https://www. cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/Value-Based-Programs/HRRP/Hospital-ReadmissionReduction-Program. Accessed February 21, 2022. Google Scholar ]. The program supports the national goal of improving health care for Americans by linking payment to the quality of hospital care. The Centers for Medicare & Medicaid Service (CMS) includes the following six condition or procedure-specific 30-day risk-standardized unplanned readmission measures in the program: Acute Myocardial Infarction, Chronic Obstructive Pulmonary Disease, Heart Failure, Pneumonia, Coronary Artery Bypass Graft Surgery, Elective Primary Hip and/or Total Knee Arthroplasty. In this issue of the Journal, John et al attempts through a prospective observational cohort study to address the issue of unplanned hospital readmission by using post discharge consultation with either general practitioners (GPs), specialist physicians or none. This study is part of phase 1 of the TARGET-READ study (Transition cAre inteRvention targeted to hiGh risk patiEnts To Reduce rEADmissions; clincialtrials.org NCTO3496896) [ [2] John G. Payrard L. Donzé J. Associations between post-discharge medical consultations and 30-day unplanned hospital readmission: A prospective observational cohort study. Eur J Intern Med. 2022; 99: 57-62https://doi.org/10.1016/j.ejim.2022.01.013 Abstract Full Text Full Text PDF Scopus (1) Google Scholar ]. Associations between post-discharge medical consultations and 30-day unplanned hospital readmission: A prospective observational cohort studyEuropean Journal of Internal MedicineVol. 99PreviewEarly readmission after hospital discharge is frequent, partly preventable, and puts a heavy burden on healthcare systems [1,2]. Many risk factors—like adverse drug events [3], physician workload [4], patients’ comorbidities [5]—and the internationally validated HOSPITAL score for 30-day potentially avoidable readmission [6] can be assessed directly during the hospital stay. However, physiological stresses experienced during hospitalization extend beyond discharge, resulting in a period of increased vulnerability [7]. Full-Text PDF Open Access