Hospital readmission for the dialysis patient: who is (not) responsible?

A new study in dialysis patients demonstrates that more than one-third of rehospitalizations within 30 days of discharge occur within the first week, and these rehospitalizations are associated with worse survival. Imposing a penalty on the dialysis provider for these rehospitalizations, as mandated by the Hospital Readmissions Reduction Program, may be inefficient in reducing health care costs and improving patient outcomes. Systems for improving communication between the hospital and posthospitalization nephrologist about patient care are needed.