Patient factors strongly predict 30-day readmissions

Editor's Note

The patient’s clinical condition responsible for admission, age, comorbidities, and socioeconomic factors such as race, income, and payer status were strong predictors of readmission within 30 days in this study.

The analysis included some 15 million patients at 611 hospitals from Premier healthcare alliance over a 2-year period.

Enactment of the Affordable Care Act has led to reduced payments from the Centers for Medicaid & Medicare Services to hospitals with readmissions exceeding an expected level. However, the readmission penalty policy does not account for the major socioeconomic factors this study finds are contributing to readmissions, the authors say.

Payment models based on stratified comparisons might result in a more equitable payment system.

Background: Under the Affordable Care Act, the Congress has mandated that the Centers for Medicare and Medicaid Services reduce payments to hospitals subject to their Inpatient Prospective Payment System that exhibits excess readmissions. Using hospital-coded discharge abstracts, we constructed a readmission measure that accounts for cross-hospital variation that enables hospitals to monitor their entire inpatient populations and evaluate their readmission rates relative to national benchmarks.