Physicians question meaning of 30 day readmission rate

Physicians from the Cleveland Clinic are questioning the reliability of the 30 day readmission rate as an indicator of poor quality. 

In the July issue of The New England Journal of Medicine, researchers examined the association between risk-adjusted readmission and risk-adjusted death within 30 days after hospitalization for heart failure using data from the CMS Hospital Compare public reporting database.

The researchers found that a higher occurrence of readmissions after index admissions for heart failure was associated with lower risk-adjusted 30-day mortality.

The researchers suggest that these findings may indicate that readmissions could be “adversely” affected because patients who die during the first episode of care can never be readmitted. Therefore, if a hospital has a lower mortality rate, then a greater proportion of its discharged patients are eligible for readmission.  The researchers call for further investigation on the 30 day readmission rate measure.

(Sources: The Advisory Board Daily Briefing, http://advisory.com, July 15, 2010; The New England Journal of Medicine, http://nejm.org, July 15, 2010)