Patient factors strongly predict 30-day readmissions

Enactment of the Affordable Care Act has led to reduced payments from the Centers for Medicare & Medicaid Services to hospitals with readmissions exceeding an expected level. However, the readmission penalty policy does not account for major socioeconomic factors that are contributing to readmissions. Payment models based on stratified comparisons might result in a more equitable payment system.

In this study, researchers at Premier Inc, Charlotte, North Carolina, used hospital-coded discharge abstracts to construct a readmission measure that accounts for cross-hospital variation, which enables hospitals to monitor their inpatient populations and evaluate their readmission rates relative to national benchmarks. The study used data on approximately 15 million patients at 611 hospitals over a 2-year period.

Results showed that the patient’s clinical condition, responsible for admission, age, and comorbidities, and socioeconomic factors such as race, income, and payer status, were strong predictors of readmission within 30 days.

The researchers concluded that payment models based on stratified comparisons would result in a more equitable payment system.

−Kroch E, Michael D, Martin J, et al. Patient factors predictive of hospital readmissions within 30 days. J Healthc Qual. 2016;38(2):106-115.

http://journals.lww.com/jhqonline/Abstract/2016/03000/Patient_Factors_Predictive_of_Hospital.7.aspx