Potentially preventable hospital returns: Seeing the full picture

Inpatient hospitalizations are often necessary — but they’re rarely easy. Even when care is delivered by skilled clinicians in well-run facilities, patients are away from home, disrupted from daily routines and exposed to the inherent risks of complex care. At the same time, inpatient services rely on highly specialized resources that drive significant cost. To deliver the greatest possible value, hospitals must look closely at what happens after discharge — especially when patients return.

Returns to the hospital often signal gaps in post-discharge care. Did the patient fully understand their discharge instructions? Were follow-up appointments scheduled and completed? Did social, behavioral or environmental factors interfere with recovery? While healthcare leaders broadly agree that unnecessary hospital returns should be reduced, meaningful improvement depends on understanding which returns are occurring and why.

Why readmissions alone don’t tell the whole story

Analyzing readmissions is an important first step — but it’s not enough. All-cause readmission measures lack the clinical context needed to guide action. A more meaningful approach focuses on clinically related returns by asking:

• What was the reason for the original hospitalization?
• What prompted the return?
• Are the two events connected?

This lens allows teams to move beyond surface-level counts and understand what is actually driving returns. By examining the clinical relationship between the initial stay and the return, providers can uncover root causes behind hospital returns, highlighting which ones were avoidable and where targeted action can reduce them in the future.
 

Emergency department visits and observation stays matter, too

Many patients are not readmitted at all, but they still return to the hospital.  Emergency department (ED) visits that are clinically related to a recent hospitalization are costly, stressful for patients and contribute to ED crowding. Observation stays that originate in the ED add another important signal. Whether driven by clinical uncertainty or reimbursement policy, these encounters reflect ongoing patient vulnerability after discharge.

Looking at inpatient readmissions, ED visits and observation stays together provides a far more complete picture of post-discharge risk.
 

Turning insight into action

With this expanded view of hospital returns, care teams can identify patterns earlier and with greater precision. Comparing performance to peer organizations or service-level benchmarks helps pinpoint where processes fall short — so improvement efforts can be targeted where they matter most.

The result? More focused interventions, better continuity of care, improved patient experiences and more efficient use of scarce hospital resources.
 

Continue the conversation on Inside Angle

This broader understanding of potentially preventable hospital returns is just the starting point. In an upcoming Inside Angle post, my colleague Travis Bias will explore how this insight fits into a much bigger challenge hospitals are facing today — and how smarter, upstream action can help disrupt the post-COVID “hospital doom loop.”

Shannon Garrison, MBA, MJ, is a health policy manager, clinical and economic research, at Solventum.