From primary care to the revolving door of hospital readmission: Relevance of Geoffrey Rose's call for a population strategy

Denny Fe G. Agana, Jason L. Salemi, Catherine W. Striley

Research output: Contribution to journalComment/debate

Abstract

The high-risk strategy in prevention has remained the preferred approach in health care. High-profile research predominantly emphasizes specific high-risk subgroups such as those who have extremely high cholesterol and super-utilizers of emergency departments. Dr. Geoffrey Rose's alternative population approach, though well established in principle, has failed to come to fruition in primary care research, aside from a few exceptions. The population approach extends intervention efforts to more moderate-risk people, attempting to shift the overall distribution in a positive direction, effecting change in more of the population. Despite requiring more initial investment due to the larger target group, the health-related gains and downstream cost savings through a population strategy may yield greater long-term cost-effectiveness than the high-risk strategy. We describe the example of extending prevention efforts from super-utilizers (e.g. those with ≥3 readmissions per year) to include those who readmit in moderate frequency (1–2 per year) in terms of potential hospital days and associated medical costs averted.

Original languageEnglish (US)
Article number100848
JournalPreventive Medicine Reports
Volume14
DOIs
StatePublished - Jun 2019

Keywords

  • Patient readmission
  • Population health
  • Preventive health

ASJC Scopus subject areas

  • Health Informatics
  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'From primary care to the revolving door of hospital readmission: Relevance of Geoffrey Rose's call for a population strategy'. Together they form a unique fingerprint.

  • Cite this