Just a quick comment regarding your editorial “Fiddling as HM Burns” (The Hospitalist, August 2011, p. 62) with regard to our hospital in the Florida Panhandle. The 60-plus patients we see daily are:
- Indigent (most) and uninsured working poor; and
- Unassigned (the local providers see their own patients).
Our length of stay is less than the providers’, but, of course, our follow-up expenses are high—we have a 15% 30-day readmission rate, and with no providers in the area that accept Medicaid, and almost no provision by the county to take care of indigent patients, the ER is the main de facto provider of healthcare. The majority of our discharges, therefore, have no follow-up plan.
I wonder if other hospitals in the Annals study (Ann Intern Med. 2011;155:152-159) had similar circumstances.
Stephen R. Gilmore, MD