Readmission rates

The US Centers for Medicare and Medicaid Services initiated public reporting of 30 day readmission rates for patients with acute myocardial infarction, pneumonia, and heart failure in 2009,1 and financial penalties began to be imposed on underperforming hospitals in 2012. Since then hospitals and health services researchers have been searching for ways to reduce hospital readmissions while trying to understand the causes and importance of readmissions. The ultimate objective is to improve care, but the path to that goal is not clear. Two linked studies help point us in the right direction.2 3

The literature on readmission rates has three general themes. The first consists of challenges to the suitability of readmission rates as quality measures,4 including their potential to decrease access to care,5 and a vexing concern regarding a possible inverse correlation between 30 day readmission for heart failure and mortality rates.6 7 The second includes studies of various interventions to reduce readmission rates,8 such as risk prediction tools.9 Studies of these efforts report mixed results, and comprehensive programs seem to be more effective than focused interventions.8 …