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Comment & Response
November 13, 2013

Preventable Acute Care Spending for Medicare Patients

Author Affiliations
  • 1Department of Family Medicine, JPS Hospital, Ft Worth, Texas
JAMA. 2013;310(18):1984. doi:10.1001/jama.2013.278604

To the Editor The study on preventable acute care spending by Dr Joynt and colleagues1 had a number of limitations. The authors did not look specifically at end-of-life costs and the savings generated by a physician who keeps a patient out of the hospital through the appropriate provision of palliative or hospice services would not be counted.

For example, if a nonambulatory patient with dementia and living in a nursing home rolled out of bed and broke her hip but did not have surgery, this event would not count as a preventable ED admission according to the methods used in the study, even though nonoperative management may be the best approach.2

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