Health Systems Failures 2: Unplanned Readmissions and Malpractice Reform


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This Week:

Reena and Amol want you to:

1. Appreciate the challenges in reducing unplanned readmissions to hospital and concerns about that metric as a quality indicator.

2. Recognize that malpractice reform in three US states did not reduce the intensity of physician practice or resource utilization, suggesting that “defensive medicine” may not be a large contributor to the escalating cost of healthcare.

Continuing Medical Education

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The papers

Dhalla IA et al. Effect of a Postdischarge Virtual Ward on Readmission or Death for High-Risk Patients: A Randomized Clinical Trial. JAMA. 2014;312(13):1305-1312. (PubMed).

Waxman DA et al. The Effect of Malpractice Reform on Emergency Department Care. N Engl J Med 2014; 371:1518-1525. (PubMed).

Good Stuff

The Quality of Fear: What the Ebola Crisis Reveals About Culture, David Brooks, New York Times, Oct 20, 2014.

Scrapping the PSA Test for Prostate Cancer is an Injustice to Men, Rocco Rossi, The Globe and Mail, Oct 28, 2014.

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