To the Editor Dr Krumholz and colleagues1 shared important data from the Centers for Medicare & Medicaid Services (CMS) demonstrating a decline in hospitalization rates and inpatient costs in the Medicare population from 1999 to 2013. The decrease in hospitalizations appeared more pronounced in the last 7 years of the analysis (6.3% for 1999-2007 vs 18.5% for 2007-2013). We suggest that one significant reason for this trend may be the increasing number of patients being placed in observation status, an outpatient category for some hospitalized patients.
Cerasale MT, Watson PY. Use of Observation Stays in Calculating Hospitalizations Among Medicare Beneficiaries. JAMA. 2015;314(24):2690-2691. doi:10.1001/jama.2015.15049