title: Comparison of rehospitalization rates in France and the United States.
abstract: OBJECTIVE
  To compare rates of 30-day all-cause rehospitalization in France and the US among patients aged 65 years and older and explain any difference between the countries.
  
  
  METHODS
  To calculate rehospitalization rates in France, we use an individual identifying variable in the national hospital administrative dataset to track unique individuals aged 65 years or more hospitalized in France in 2010. To calculate the proportion of rehospitalized patients (65+) who received outpatient visits between the time of initial discharge and rehospitalization, we linked the hospital database with a database that includes all medical and surgical admissions. We used step by step regression models to predict rehospitalization.
  
  
  RESULTS
  Rates of rehospitalization in France (14.7%) are lower than among Medicare beneficiaries in the US (20%). We find that age, sex, patient morbidity and the ownership status of the hospital are all correlated with rehospitalization in France.
  
  
  CONCLUSIONS
  Lower rates of rehospitalization in France appear to be due to a combination of better access to primary care, better health among the older French population, longer lengths of stay in French hospitals and the fact that French nursing homes do not face the same financial incentive to rehospitalize residents.
authors.affiliation: Research Scholar, Research department, The Hastings Center, New York, USA gusmanom@thehastingscenter.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Gusmano
authors.affiliation: Professor, The Robert F. Wagner School of Public Service, New York University, New York, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Rodwin
authors.affiliation: Associate Research Scientist, The Robert N. Butler Columbia Center on Aging, Columbia University - International Longevity Center, New York, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisz
authors.affiliation: Statistician, Service de Biostatistique et d'Informatique Médicale (DIM), Centre Hospitalier Universitaire, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cottenet
authors.affiliation: Researcher, Service de Biostatistique et d'Informatique Médicale (DIM), Centre Hospitalier Universitaire, Dijon, France Researcher, INSERM U866, Université de Bourgogne, France Researcher, INSERM, CIC1432, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005602:France; D006302:Health Services Research; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States
keywords: France; health policy; rehospitalization