Featured Research

from universities, journals, and other organizations

Same-hospital readmission rate an unreliable predictor for all-hospital readmission rate

Date:
October 8, 2013
Source:
American College of Surgeons
Summary:
According to new research findings presented at the 2013 Clinical Congress of the American College of Surgeons, same-hospital readmission rates are an unreliable surrogate for predicting all-hospital readmissions rates.

Approximately one in five Medicare patients are rehospitalized within 30 days of discharge. The Centers for Medicare & Medicaid Services (CMS) considers this rate excessive, and began reducing payments to hospitals that have excessive readmission rates in October 2012 under a provision of the Patient Protection and Affordable Care Act. While the Hospital Readmissions Reduction Program penalizes readmission to any hospital, most hospitals are only tracking same-hospital readmissions using administrative data that is recorded for billing purposes. However, according to new research findings presented at the 2013 Clinical Congress of the American College of Surgeons, same-hospital readmission rates are an unreliable surrogate for predicting all-hospital readmissions rates.

Related Articles


"With increasing penalization for readmissions rates, hospitals need complete information to effectively target areas for quality improvement," said study coauthor Andrew Gonzalez, MD, JD, MPH, a research fellow in vascular surgery at the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor. "Under the current model, hospitals are attempting to solve the readmissions problem without havng all the puzzle pieces-they know about read-missions to their own facilities, but not about readmissions to other facilities."

For the University of Michigan study, researchers evaluated three years of data on 660,700 Medicare patients undergoing one of three major surgical operations: coronary artery bypass grafts, hip fracture repair, and colectomy. Within this group, 86,200 patients (about 13 percent overall), had at least one readmission within 30 days of their operation. Within that 13 percent, 54,264, or about two-thirds, were readmitted to the same hospital.

Using patient level data, the researchers generated risk-adjusted rates of same-hospital and all-hospital readmissions. They then ranked hospitals from lowest to highest readmission rates and divided them into five groups (quintiles) based upon their ranking. The authors then compared how hospital performance based upon same-hospital readmission rate compared with performance under all-hospital readmissions, and found that 42 percent of hospitals were reclassified into a different quintile of performance. For example, of hospitals performing in the top quintile based on same-hospital readmission, nearly a quarter (24 percent) were reclassified when rankings were based on all-hospital readmission. This pattern was most exaggerated in the median quintile, where 55 percent were reclassified under all-hospital readmissions rankings.

"When you look at reclassification over all of the quintiles of performance, the take home message is that about 42 percent of hospitals reclassify," Dr. Gonzalez said. "Unless you are a top or bottom performer for readmissions, your same-hospital readmission rate may be very misleading. That's why using the same-hospital readmission rate is an unreliable predictor for your all-hospital readmission rate, but that rate is exactly what CMS penalizes hospitals for."

The researchers conclude that in order to decrease readmissions and improve quality of care, hospitals need to have access to real-time data. This access could come in a number of forms, including a surgical quality improvement collaborative where information is quickly and easily exchanged among participants.

"As it currently stands, CMS sends institutions annual hospital-specific reports," Dr. Gonzalez explained. "These reports include the institution's all-hospital readmission rate, and, moreover, the provider IDs for all the other hospitals to which an institution's patients were readmitted. Yet upon receipt, the information is already a year old. The incorporation of real-time data might significantly improve the efficiency of the quality improvement cycle."


Story Source:

The above story is based on materials provided by American College of Surgeons. Note: Materials may be edited for content and length.


Journal Reference:

  1. Geoffrey Gerhardt, Alshadye Yemane, Peter Hickman, Allison Oelschlaeger, Eric Rollins, Niall Brennan. Medicare Readmission Rates Showed Meaningful Decline in 2012. Medicare & Medicaid Research Review, 2013; 3 (2): E1 DOI: 10.5600/mmrr.003.02.b01

Cite This Page:

American College of Surgeons. "Same-hospital readmission rate an unreliable predictor for all-hospital readmission rate." ScienceDaily. ScienceDaily, 8 October 2013. <www.sciencedaily.com/releases/2013/10/131008112533.htm>.
American College of Surgeons. (2013, October 8). Same-hospital readmission rate an unreliable predictor for all-hospital readmission rate. ScienceDaily. Retrieved December 20, 2014 from www.sciencedaily.com/releases/2013/10/131008112533.htm
American College of Surgeons. "Same-hospital readmission rate an unreliable predictor for all-hospital readmission rate." ScienceDaily. www.sciencedaily.com/releases/2013/10/131008112533.htm (accessed December 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, December 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Buzz60 (Dec. 19, 2014) A double-amputee makes history by becoming the first person to wear and operate two prosthetic arms using only his mind. Jen Markham has the story. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins