Dynamic Chiropractic - September 23, 1996, Volume 14, Issue 20

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Medical Primary Care

A recent published study reports on efforts to reduce the amount of hospital readmissions of chronically ill patients by increased access to primary care MDs and nurses after discharge from the hospital. A group of discharged hospital patients receiving primary care (intervention group), was compared to the control group that received standard discharge care. The researchers expected to see fewer readmissions in the primary care group, but just the opposite happened, and the intervention group had longer rehospitalization stays:


Number of Hospital Readmissions Per Month:

Intervention Group - 19
Control Group - 14

Average Number of Days of Rehospitalization:

Intervention Group - 10.2
Control Group - 8.8

If, as this study shows, greater use of medical primary care translates to increased hospital readmissions and longer hospital stays, what does this say about the use of MDs and nurses as gatekeepers?

SOURCE: Weinberger M, Oddone EZ, Henderson WG. Does increase access to primary care reduce hospital readmission? N England J Med 1996;334(22):1441-7.