Study: 30-day readmission rates are an inaccurate quality measurement
- 30-day readmission rates don’t reflect clear quality differences from one hospital to another, according to a study in Health Affairs' most recent issue.
- Readmissions occurring seven days or more beyond an initial discharge were explained by community- and household-level factors.
- Using shorter intervals of five or seven days would likely improve the accuracy of readmissions as a quality measurement, the researchers concluded.
Beyond seven days, a patient’s home, social, economic, and community circumstances are more likely to drive readmissions than any hospital-specific factor, senior author Patrick Romano, UC Davis professor of general medicine, told Medical Xpress. The researchers were not the first to draw into the question the accuracy of 30-day readmission rates as a quality measure.
In a study of National Veterans Affairs Surgical Quality Improvement Program data, published this month in Annals of Surgery, researchers conducted a similar investigation and determined that readmission rates were a poor quality measurement since it is too difficult for hospitals to predict which patients will be readmitted. In a 2015 analysis of the Hospital Readmission Reduction Program, the American Hospital Association argued that payment models using readmission rates as a quality reporting measure would unfairly penalize hospitals providing care to predominantly high-risk populations.
While criticism of readmission rates as a quality measure seems warranted, they could also be working. In September, CMS announced all states had reduced 30-day readmission rates since 2010. In a Health Affairs study published in September, researchers found that readmission rates at safety-net hospitals have fallen more than at other types of hospitals.
- Health Affairs Rethinking Thirty-Day Hospital Readmissions: Shorter Intervals Might Be Better Indicators Of Quality Of Care
- Annals of Surgery Postoperative 30-day Readmission: Time to Focus on What Happens Outside the Hospital
- American Hospital Association Trendwatch: Rethinking the Hospital Readmissions Reduction Program
- Healthcare Dive CMS: Nearly all states reduced preventable hospital readmissions
- Healthcare Dive Safety-net hospitals reduce readmissions amid fairness concerns