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Reducing readmissions to hospital.


Reducing readmission of patients to hospital after their initial discharge is a priority for many health systems because of the considerable public health impact and financial cost of these readmissions. For example, in England, there are around 535 000 readmissions annually in patients aged 16 years or older. About 11.2% of hospital admissions result in readmission, and there is a wide variation between both general practices and primary care trusts. I discuss the experience of England in this area in a publication in the Annals of Internal Medicine. A number of initiatives have aimed to reduce hospital readmissions in England but their success has generally been limited. The most recent initiative - the success of which remains to be assessed - is to give general practitioners more control of NHS budgets. Giving physicians collective responsibility for health service budgets in their locality in an attempt to improve the efficiency of a health system  is a radical step and one that we should observe closely to learn about the benefits and also to identify any unintended adverse consequences.

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