Reducing hospital readmission rates is an important clinical and policy priority but whether those rates really measure the quality of hospital care isn’t clear. In a new study, researchers from Harvard School of Public Health (HSPH) found strong evidence of a relationship between surgical readmission rates and quality of surgical care. The finding provides an opportunity for policymakers to improve surgical quality and decrease readmission costs and supports plans by the Centers for Medicare and Medicaid Services to expand its readmission penalty program to include surgical procedures.“Our findings suggest that focusing on surgical readmissions may be a smart policy approach to both improving care and reducing unnecessary spending,” said Ashish Jha, professor of health policy at HSPH and the study’s senior author.The study appears in the Sept. 19, 2013 issue of the New England Journal of Medicine.Much of the policy focus to date has been on reducing readmissions after hospitalization for medical conditions, such as heart failure and pneumonia, but this approach has been controversial. Readmissions for medical conditions are primarily driven by how sick the patients are and whether they live in poor or better-off communities; the link between hospital quality and readmissions is less clear. The authors postulated that surgical care may be different—and sought to find out if there was a relationship between readmission rates after surgery and the quality of surgical care in that hospital. Read Full Story
If you can boast of anything Florentino Pérez is to be the President with best record of Real Madrid after Santiago Bernabeu: In his two stages at the helm of the white club, he has won four Leagues, five Champions, two Copa del Rey, one Intercontinental, four Club World Cups, four European Super Cups and four other Spanish Super Cups. And although his first season as president of Madrid (2000-2001) he was a true success, with the galactic signing of Figo and the conquest of the leagueFlorentino met the bitter taste of defeat as soon as he arrived in his first two finals as president of the white club, in the European Super Cup against Galatasaray and at the Intercontinental before Boca Juniors. Real Madrid came from win the eighth in Paris against Valencia (3-0) with a team that ended fifth in LaLiga and what did you find in the interim Vicente del Bosque, who had replaced Toshack in the mid 99/00, a full man Able to know how to deal with a locker room full of egos, as historically has been the target, and turn it into a champion team. The then president Lorenzo Sanz, overwhelmed by his recent wins (two Champions in three years) called elections under the guarantee of his sporting successes, which made him think he was invincible, and took a setback. Florentino beat him at the polls with the promise to the members that he would sign the Barcelona player Luis Figo, considered then the best player in the world, for 60 million euros. Florentino was contractually tied to the Portuguese, who reached an agreement with the candidate with the idea of putting pressure on Barça to improve his salary assuming that Sanz would win the elections. But Florentino got away with it.In addition to the Portuguese, Pérez signed that year Caesar for goal, to Munitis and Solari to reinforce the attack and Flavio Conçeicao, Celades and Makelele to replace the loss of Fernando Redondo, one of the closest men to Lorenzo Sanz in the white dressing room. Round had been the game director Madrid in six previous seasons, in which Madrid won two Champions, two Leagues and an Intercontinental and in which the Argentinean alone took the baton from the midfield of Madrid, and his low was noticed in the first matches of the new Florentine stage. In fact, Florentino’s first official meeting as manager of Real Madrid was the final of the European Super Cup that faced whites with the UEFA champion Galatasaray, and it turned out to be his first big stick as president. Mircea Lucescu had collected the reins of the Galatasaray after the Fatih Terim march, that same summer he signed for Milan as soon as he won UEFA. The transfer of powers between two of the best technicians in the history of Eastern Europe could not have started better. In the first Super Cup that faced the champion of the Champions League with that of UEFA (previously the Recopa champion went) the Turks, led by Jardel and Hagi they beat Madrid in overtime (2-1) with a golden goal from the Brazilian striker, who had already scored the previous goal for his team (Raúl scored the goal for Madrid) and which left Florentino without his first title and what would have been the first European Super Cup in the white cabinets . Few moths later it was Boca Juniors in the Intercontinental Cup who would postpone Florentino’s first success. Carlos Bianchi he directed the Buenos Aires team, which had just won the Libertadores at the start of one of the best stages in its history (the Argentines would achieve three liberators in four years), with two players who stood out above the rest: Martín Palermo and Juan Román Riquelme. Boca won (2-1) but the result was short after seeing what happened on the grass. Argentines they danced to Madrid with a spectacular Riquelme and Palermo made both goals from Buenos Aires shortly after the match started. The goal of Roberto Carlos it only served to make up the marker.Despite these two hard knocks, the Madrid was a real hammer pylon in the League. Makelele took the position in the midfield, Figo took very little in adapting to the team and Raúl, who finished pichichi, He led a team that successfully won the domestic competition. To the next year The Ninth would come and two seasons later Florentino removed the thorn from his first months as president with the conquest of the Supercup against Feyenoord (3-1) and the Intercontinental against Olimpia de Paraguay (2-1).