HealthDay News — Hospital quality contributes to readmission rates independent of factors involving patients, according to a study published in the New England Journal of Medicine.
Harlan M Krumholz, MD, from the Yale-New Haven Hospital in Connecticut, and colleagues divided the Centers for Medicare & Medicaid Services hospital-wide readmission measure cohort into 2 random samples. The first was used to calculate the risk-standardized readmission rate within 30 days for each hospital, with hospitals classified into performance quartiles.
The study sample identified from the second sample included patients with 2 admissions for similar diagnoses at different hospitals. Readmission rates were compared among patients who had been admitted to hospitals in different performance quartiles.
The researchers found that the median risk-standardized readmission rate was 15.5% in the performance-classification sample. In the study sample (37,508 patients with 2 admissions for similar diagnoses at 4272 different hospitals), the observed readmission rate was higher for patients admitted to hospitals in a worse-performing versus a better-performing quartile.
The only significant difference was seen when patients were admitted to hospitals in which one was in the best-performing and one in the worst-performing quartile (absolute difference in readmission rate, 2% points).
“The findings suggest that hospital quality contributes in part to readmission rates independent of factors involving patients,” the authors write.
- Krumholz HM, Wang K, Lin Zhenqiu, et al. Hospital-readmission risk — isolating hospital effects from patient effects. N Engl J Med. 2017; 377: 1055-1064.