Association of changing hospital readmission rates with mortality rates after hospital discharge

JAMA - Journal of the American Medical Association

Volumn 318, Issue 3, 2017, Pages 270-278

  Dharmarajan, Kumar ^a,b   Wang, Yongfei ^b,c   Lin, Zhenqiu ^d,e   Normand, Sharon Lise T ^b   Ross, Joseph S ^f   Horwitz, Leora I ^g   Desai, Nihar R ^h   Suter, Lisa G ^h   Drye, Elizabeth E ^b   Bernheim, Susannah M ^b   Krumholz, Harlan M ^a  

^a YALE NEW HAVEN HEALTH SYSTEM   (United States)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c Now with Clover Health   (United States)

^d HARVARD MEDICAL SCHOOL   (United States)

^e HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^f YALE UNIVERSITY   (United States)

^g NEW YORK UNIVERSITY MEDICAL CENTER   (United States)

^h NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE HEART INFARCTION; AGED; ARTICLE; CORRELATIONAL STUDY; FEMALE; HEART FAILURE; HOSPITAL DISCHARGE; HOSPITAL MORTALITY; HOSPITAL READMISSION; HOSPITALIZATION; HUMAN; INCIDENCE; MAJOR CLINICAL STUDY; MALE; MEDICARE; MORTALITY RATE; PNEUMONIA; PRIORITY JOURNAL; RETROSPECTIVE STUDY; EPIDEMIOLOGY; HEALTH CARE POLICY; HEART INFARCTION; MEDICAL FEE; MORTALITY; RISK ASSESSMENT; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES;

AGED; FEE-FOR-SERVICE PLANS; HEART FAILURE; HOSPITALIZATION; HUMANS; MEDICARE; MORTALITY; MYOCARDIAL INFARCTION; PATIENT DISCHARGE; PATIENT PROTECTION AND AFFORDABLE CARE ACT; PATIENT READMISSION; PNEUMONIA; RETROSPECTIVE STUDIES; RISK ADJUSTMENT; UNITED STATES;

EID: 85025834921     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.2017.8444     Document Type: Article

References (40)

1. Zuckerman RB, Sheingold SH, Orav EJ, Ruhter J, Epstein AM. Readmissions, observation, and the Hospital Readmissions Reduction Program. N Engl J Med. 2016;374(16):1543-1551.
2. Naylor MD, Kurtzman ET, Grabowski DC, Harrington C, McClellan M, Reinhard SC. Unintended consequences of steps to cut readmissions and reform payment may threaten care of vulnerable older adults. Health Aff (Millwood). 2012;31(7):1623-1632.
3. Himmelstein D,Woolhandler S. Quality improvement: 'become good at cheating and you never need to become good at anything else.' Health Affairs Blog. August 27, 2015. http://healthaffairs.org/blog/2015/08/27/quality-improvement-become-good-At-cheating-And-you-never-need-to-become-good-At-Anything-else/. Accessed November 12, 2016.
4. Carlson J. Faulty gauge? Readmissions are down, but observational-status patients are up-And that could skew Medicare numbers. Modern Healthcare. June 8, 2013. http://www.modernhealthcare.com/article/20130608/magazine/306089991. Accessed November 12, 2016.
5. McIlvennan CK, Eapen ZJ, Allen LA. Hospital Readmissions Reduction Program. Circulation. 2015;131(20):1796-1803.
6. Gorodeski EZ, Starling RC, Blackstone EH. Are all readmissions bad readmissions? N Engl J Med. 2010;363(3):297-298.
7. Werner RM, Bradlow ET. Public reporting on hospital process improvements is linked to better patient outcomes. Health Aff (Millwood). 2010;29 (7):1319-1324.
8. Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly: a randomized clinical trial. Ann Intern Med. 1994;120(12):999-1006.
9. Coleman EA, Parry C, Chalmers S, Min SJ. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med. 2006; 166(17):1822-1828.
10. Brewster AL, Cherlin EJ, Ndumele CD, et al. What works in readmissions reduction: how hospitals improve performance. Med Care. 2016;54 (6):600-607.
11. Hernandez AF, Greiner MA, Fonarow GC, et al. Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA. 2010;303(17): 1716-1722.
12. Ouslander JG, Bonner A, Herndon L, Shutes J. The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: an overview for medical directors and primary care clinicians in long term care. J AmMed Dir Assoc. 2014;15(3):162-170.
13. Brotman DJ, Hoyer EH, Leung C, Lepley D, Deutschendorf A. Associations between hospital-wide readmission rates and mortality measures at the hospital level: are hospital-wide readmissions a measure of quality? J HospMed. 2016;11(9):650-651.
14. Krumholz HM, Lin Z, Keenan PS, et al. Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia. JAMA. 2013;309(6):587-593.
15. Joynt KE, Figueroa JE, Oray J, Jha AK. Opinions on the Hospital Readmission Reduction Program: results of a national survey of hospital leaders. Am J Manag Care. 2016;22(8):e287-e294.
16. Keenan PS, Normand SL, Lin Z, et al. An administrative claims measure suitable for profiling hospital performance on the basis of 30-day all-cause readmission rates among patients with heart failure. Circ Cardiovasc Qual Outcomes. 2008;1(1):29-37.
17. Krumholz HM, Lin Z, Drye EE, et al. An administrative claims measure suitable for profiling hospital performance based on 30-day all-cause readmission rates among patients with acutemyocardial infarction. Circ Cardiovasc Qual Outcomes. 2011;4(2):243-252.
18. Lindenauer PK, Normand SL, Drye EE, et al. Development, validation, and results of a measure of 30-day readmission following hospitalization for pneumonia. J HospMed. 2011;6(3):142-150.
19. Krumholz HM,Wang Y, Mattera JA, et al. An administrative claims model suitable for profiling hospital performance based on 30-day mortality rates among patients with an acute myocardial infarction. Circulation. 2006;113(13): 1683-1692.
20. Krumholz HM,Wang Y, Mattera JA, et al. An administrative claims model suitable for profiling hospital performance based on 30-day mortality rates among patients with heart failure. Circulation. 2006;113(13):1693-1701.
21. American Hospital Association. Average length of stay in community hospitals, 1994-2014. http://www.aha.org/research/reports/tw/chartbook/2016/chart3-5.pdf. Accessed February 12, 2017.
22. Drye EE, Normand SL,Wang Y, et al. Comparison of hospital risk-standardized mortality rates calculated by using in-hospital and 30-day models: an observational study with implications for hospital profiling. Ann Intern Med. 2012; 156(1, pt 1):19-26.
23. Horwitz LI, Grady JN, Cohen DB, et al. Development and validation of an algorithm to identify planned readmissions from claims data. J HospMed. 2015;10(10):670-677.
24. Desai NR, Ross JS, Kwon JY, et al. Association between hospital penalty status under the Hospital Readmission Reduction Program and readmission rates for target and nontarget conditions. JAMA. 2016;316(24):2647-2656.
25. Bhalla R, Kalkut G. Could Medicare readmission policy exacerbate health care system inequity? Ann Intern Med. 2010;152(2):114-117.
26. Joynt KE, Jha AK. Characteristics of hospitals receiving penalties under the Hospital Readmissions Reduction Program. JAMA. 2013;309 (4):342-343.
27. Joynt KE, Jha AK. A path forward on Medicare readmissions. N Engl J Med. 2013;368(13):1175-1177.
28. Gu Q, Koenig L, Faerberg J, Steinberg CR, Vaz C, WheatleyMP. The Medicare Hospital Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations. Health Serv Res. 2014;49 (3):818-837.
29. Carey K, Lin MY. Hospital Readmissions Reduction Program: safety-net hospitals show improvement, modifications to penalty formula still needed. Health Aff (Millwood). 2016;35(10):1918-1923.
30. Kociol RD, Peterson ED, Hammill BG, et al. National survey of hospital strategies to reduce heart failure readmissions: findings from the Get With the Guidelines-Heart Failure registry. Circ Heart Fail. 2012;5(6):680-687.
31. Bradley EH, Curry L, Horwitz LI, et al. Hospital strategies associated with 30-day readmission rates for patients with heart failure. Circ Cardiovasc Qual Outcomes. 2013;6(4):444-450.
32. Bradley EH, Sipsma H, Horwitz LI, et al. Hospital strategy uptake and reductions in unplanned readmission rates for patients with heart failure: a prospective study. J Gen Intern Med. 2015; 30(5):605-611.
33. Joynt KE, Orav EJ, Zheng J, Jha AK. Public reporting of mortality rates for hospitalized Medicare patients and trends in mortality for reported conditions. Ann Intern Med. 2016;165(3): 153-160.
34. Chen J, Normand SL,Wang Y, Krumholz HM. National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998-2008. JAMA. 2011;306(15): 1669-1678.
35. Chen J, Dharmarajan K,Wang Y, Krumholz HM. National trends in heart failure hospital stay rates, 2001 to 2009. J AmColl Cardiol. 2013;61(10):1078-1088.
36. Yeh RW, Sidney S, ChandraM, Sorel M, Selby JV, Go AS. Population trends in the incidence and outcomes of acutemyocardial infarction. N Engl J Med. 2010;362(23):2155-2165.
37. Sacks NC, Ash AS, Ghosh K, et al. Recent national trends in acutemyocardial infarction hospitalizations in Medicare: shrinking declines and growing disparities. Epidemiology. 2015;26(4): e46-e47.
38. Nallamothu BK, Normand SL,Wang Y, et al. Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study. Lancet. 2015;385(9973):1114-1122.
39. Krumholz HM, Nuti SV, Downing NS, Normand SL,Wang Y. Mortality, hospitalizations, and expenditures for the Medicare population aged 65 years or older, 1999-2013. JAMA. 2015;314(4): 355-365.
40. Figueroa JF, Tsugawa Y, Zheng J, Orav EJ, Jha AK. Association between the Value-Based Purchasing pay for performance program and patient mortality in US hospitals: observational study. BMJ. 2016;353:i2214.