"Given the breadth of risk factors we identified, it seems likely that more intensive interventions will require a multidisciplinary approach, one which might be costly if applied broadly. Our study does not attempt to predict who will be readmitted and who will not, but rather provides a list of risk factors which might be used to deploy resources more efficiently."
"The US spends over $15 billion in Medicare on readmissions to hospital within 30 days and readmissions are also distressing to patients and their caregivers," Allaudeen, now based at the VA Palo Alto Health Care System, California, said in a statement. "Many healthcare systems are now making efforts to improve the transition from hospital to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact. Studies like ours should give practitioners direction to non-clinical factors to identify."
She and her colleagues note that further, in-depth research is needed—research that incorporates the patient experience. "Both black race and Medicaid as payer are proxies for the underlying root cause aspects leading to readmission, such as access to longitudinal care. Following this trail to the ‘root cause’ will require in-depth qualitative evaluation that includes the patient perspective as a source of data," they write.
The authors place this task with the hospitalist. "Hospitalists, who are at nexus of the discharge process and uniquely invested in quality inpatient care, are ideally positioned to lead efforts to reduce readmissions."