Author Affiliations: University of Connecticut, Mansfield Family Practice, Storrs, Connecticut (Dr Dardick) (kdardick@gmail.com); and Center for Medicare Advocacy, Willimantic, Connecticut (Ms Stein).
To the Editor: A Commentary by Drs Kangovi and Grande discussed factors that influence hospital readmission rates.1 Patients who are cared for under observation status are not counted in readmission rates. Medpac reported that from 2006 to 2008 the number of hours attributed to observation increased by 32%.2
Kangovi and Grande stated, “CMS [Centers for Medicare & Medicaid Services] should monitor . . . observation service use . . . ”, yet their Figure ignores this and they do not discuss how this would affect their conclusions. No discussion of readmission rates can be considered valid without taking into account those hospital stays that are counted as observation and which may lead to an underestimation of readmission rates by as much as 32%.
Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Ms Stein reported a grant from Atlantic Philanthropies to challenge illegal barriers to Medicare coverage, and payment for developing and participating in presentations for legal and medical professionals interested in Medicare rights. Dr Dardick reported no disclosures.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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