In Reply: We agree with Dr Cakir that key factors at both the patient level and hospital level likely account for some of the disparities we found between black and white patients and between minority-serving and non–minority-serving hospitals. Cakir suggests living conditions, low income, low health literacy, and access to primary care as possible patient-level contributors to disparities in readmission rates, and we agree that any one of these factors may be important—and more likely, all of them are. Prior studies have found an association between SES and readmissions,1- 4 although SES was defined differently in each study. Further work to delineate the precise contribution of different sociodemographic variables, particularly as policy makers work to develop interventions to reduce disparities in this health outcome, would be helpful.
Joynt KE, Orav EJ, Jha AK. Race, Site of Care, and Hospital Readmission Rates—Reply. JAMA. 2011;305(19):1965–1966. doi:10.1001/jama.2011.641