Key Findings. In this study of more than 43,000 home health episodes following a hospitalization, handoffs between skilled nursing providers--a marker of discontinuity of care--substantially increased hospital readmissions, and were more detrimental for sicker patients. The estimates imply that a single handoff increases the likelihood of 30-day hospital readmission by 16% and that one in four hospitalizations during home health care could be avoided if handoffs were eliminated.
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