Surgical-Readmission Rates and Quality of Care To the Editor: Tsai and colleagues (Sept. 19 issue)1 have shown a correlation among surgical volume, mortality, and readmission rates, advocating for the use of readmission rates in health care penalty programs. Although no significant difference was identified in surgical-readmission rates between urban and rural hospitals (P = 0.99), more than half of the hospitals excluded from analysis were rural centers that provide acute care to Medicare recipients. In addition, higher readmission rates were reported from hospitals in low-income areas (P