YNHH study: Most hospital readmissions within 7 days aren’t preventable

Most patients who return to the hospital within a week of being discharged are readmitted for reasons that could not have been prevented through better hospital care or discharge planning, according to a new Yale New Haven Health study. The study, published last month in the Journal of General Internal Medicine, examined 244 readmissions involving 204 adult patients who returned to Yale New Haven Hospital within seven days of being discharged in 2025. Researchers determined that just 10.2% of the readmissions were potentially preventable through improvements in inpatient care or the discharge process. The potentially preventable cases involved diagnostic or management errors, medication-related issues or inadequate follow-up arrangements. Instead, the study found, chronic disease progression accounted for 39.8% of readmissions, while 32% were attributed to new illnesses or injuries and 15.6% to either mental health or substance-use conditions. The findings challenge the assumption that patients who return shortly after being discharged generally reflect shortcomings in hospital care, Yale New Haven Health said. Hospital readmission rates are commonly tracked as a measure of healthcare quality. “Hospitals have invested heavily in reducing readmissions, but our study suggests that many patients who return within seven days are facing underlying health challenges that cannot be solved through discharge planning alone,” said Dr. Erin McKnight, associate director of the hospitalist service at Yale New Haven Hospital and assistant clinical professor of general internal medicine at Yale School of Medicine. “To make meaningful progress, we need stronger support systems that extend beyond the hospital and into the community,” McKnight said. The study also highlights the medical complexity of patients who quickly return to the hospital. Nearly 70% had been hospitalized at least once during the preceding year, and 20% died within six months. Hospital readmissions also carry financial consequences for hospitals and the healthcare system. Under the federal Hospital Readmissions Reduction Program, the Centers for Medicare and Medicaid Services reduces Medicare payments to hospitals with excess 30-day readmissions for six conditions and procedures, including heart failure, pneumonia and chronic obstructive pulmonary disease. Payment reductions can reach 3% of a hospital's Medicare fee-for-service base operating payments. Readmissions can also be costly in their own right. A 2023 statistical brief from the federal Agency for Healthcare Research and Quality, using 2020 national data, found that the average 30-day hospital readmission cost $16,300 — 12.4% more than the $14,500 average cost of the initial hospital stay. The Yale study did not examine the cost of readmissions nor hospitals' exposure to federal readmission penalties, and its seven-day readmission measure differs from the 30-day period used in the federal program and AHRQ analysis Yale researchers said further reducing readmissions may require greater access to outpatient services rather than additional hospital-based interventions. The study specifically identified expanded outpatient palliative care — reducing pain, stress, or the severity of a disease without curing its underlying cause — and rapid access to addiction treatment as potential opportunities. Researchers also cautioned that the study was conducted at a single urban academic hospital, which could limit how broadly its findings apply to community hospitals and other settings.