title: Strategies to Reduce Hospital Readmissions.
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.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota.
authors.forename: Sakkarin
authors.initials: S
authors.lastname: Chirapongsathorn
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota.
authors.forename: Jayant A
authors.initials: JA
authors.lastname: Talwalkar
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, College of Medicine, Rochester, Minnesota.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Kamath
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000191:economics*; D058625:End Stage Liver Disease / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000191:economics*; D058991:Patient Protection and Affordable Care Act; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States