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Semin Liver Dis 2016; 36(02): 161-166
DOI: 10.1055/s-0036-1583196
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Strategies to Reduce Hospital Readmissions

Sakkarin Chirapongsathorn
1   Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota
2   Division of Gastroenterology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Royal Thai Army, Bangkok, Thailand
,
Jayant A. Talwalkar
1   Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota
,
Patrick S. Kamath
1   Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota
› Author Affiliations
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Publication History

Publication Date:
12 May 2016 (online)

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Abstract

After the Patient Protection and Affordable Care Act or “Obamacare” was signed into law in 2010, the problem of readmission has taken on a new sense of urgency. Hospitals with excess readmissions receive reduced reimbursement because readmission is considered to represent a poor quality measure in the healthcare delivery system. Cirrhosis places a major burden on the healthcare economy. Patients with cirrhosis frequently require hospitalization, and annual admission rates have doubled within 10 years. The costs of hospitalization associated with cirrhosis have also markedly increased. Readmissions create negative consequences for the patient and the family. Several strategies have been proposed to reduce the number of readmissions, but the efficacy of these strategies is questionable. Although the Model for End-Stage of Liver Disease (MELD) score can be a tool for risk stratification, many other factors are also independent risks for readmission. Studies aimed at the reduction of readmission in patients with cirrhosis are very limited, and much research is required before specific recommendations can be made to reduce readmissions.

Keywords

cirrhosis - readmission - complications of cirrhosis - healthcare delivery - MELD score
 

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