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Improved discharge directions and communication between patients and providers could prevent up to 27% of hospital readmissions, according to a new study.

Researchers at the University of California, San Francisco reviewed 1,000 hospital readmissions that occurred within 30 days of discharge, and found that 269 of those cases were potentially preventable. Results of the study were published online in JAMA Internal Medicine on Monday.

The most common factors for readmission were emergency room decision-making, premature discharge, and lack of communication between patients and providers about post-discharge appointments, contacts and care wishes. Patients who were readmitted often didn’t follow up with post-discharge appointments, or know who to contact about health concerns after discharge, researchers said.

“We were also surprised by the large role which improving communication and confirmation of care plans between patients, acute care, and longitudinal care providers might provide in reducing readmissions,”  lead researcher Andrew Auerbach, M.D., told Reuters. “These efforts should focus on understanding whether a patient is truly able to care for himself after discharge, whether the care offered is consistent with his wishes, and on developing systems which can keep patients out of the hospital yet able to access certain aspects of hospital care.”