Hospitals with high readmission rates linked have higher patient risks study finds
New Haven, Conn. — Patients admitted to hospitals with higher readmission rates are more like to experience hospital complications, a new study by researchers at the Yale Center for Outcomes Research Evaluation (CORE) and funded by Agency for Healthcare Research and Quality (AHRQ) has found.
The study, focused on patients hospitalized with pneumonia, shows that hospital readmissions and hospital complication rates are related for patients with pneumonia. Examples of these complications, or adverse events, include the need for a life-saving intervention, an extended hospital stay, an event causing permanent harm, or in some cases, death.
The study was published in the JAMA Network Open on May 31, 2022.
“This finding strengthens the evidence that hospital readmission rates reflect the quality of hospital care for pneumonia patients,” said Dr. Harlan Krumholz, the senior author of the study, director of CORE, and the Harold H. Hines Jr. Professor of Medicine at Yale School of Medicine. “Furthermore, the data suggest that the factors to promote better outcomes in reducing unplanned readmission may also support higher patient safety performance as indicated by lower rates of adverse events.”
Since 2008, the Centers for Medicare and Medicaid Services (CMS) has publicly reported hospital risk-standardized readmission rates. These rates are used in the CMS Hospital Readmission Reduction Program, which levies penalties on hospitals with higher-than-average readmission rates. In addition to controlling costs, lower hospital readmission rates are associated with better care coordination and improved patient satisfaction. The authors of the study sought to determine if a hospital’s readmission rate is also reflective of its overall quality.
The study found that pneumonia patients admitted to hospitals with high all-cause readmission rates were more likely to develop adverse events during the index hospitalization. Specifically, an increase by one interquartile range in the admitted hospital’s readmission rate was associated with a relative 14 percent higher patient risk of adverse events and five more adverse events per 1,000 discharges.
In 1999, the Institute of Medicine published “To Err is Human: Building a Safer Health System ,” drawing national attention to the problem of medical errors in hospitals and calling for healthcare providers to design and implement processes to improve patient safety.
In 2002, the Medicare Patient Safety Monitoring System (MPSMS) was created under the auspices of the U.S. Department of Health and Human Services’ Patient Safety Task Force. The MPSMS is a chart-abstracted surveillance system that measures patient safety by tracking the rates of adverse events associated with specific hospital care delivery processes within the hospitalized adult population.
This cross-sectional study linked patient-level adverse events data from the MPSMS and hospital-level pneumonia-specific all-cause readmissions data from the Centers for Medicare and Medicaid Services for pneumonia patients discharged between July 1, 2010 and December 31, 2019.
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