Yet another study, this one carried by Health Services Research, suggests that current methods for encouraging fewer inappropriate hospital readmissions are inadequate to avoid wrongly punishing hospitals for events beyond their control.
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CMS is extending hospital readmission penalties to surgeries. An article in the Journal of the American Medical Association examines reasons for such readmissions, which is kind of a core predicate to having a reduction initiative.
A paper from the National Bureau of Economic Research challenges the contemporary view and finds that keeping patients in a hospital longer may reduce readmissions in some cases.
CMS' program to use community aging agencies to help cut hospital readmissions shows dismal early results, as only 4 out of 48 of the agencies involved showed meaningful decreases.
http://kaiserhealthnews.org/news/health-law-test-to-cut-readmissions-lacks-early-results/?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=15584116&_hsenc=p2ANqtz--tbPtkv-ME_YzKiQwxJsySYmA3Sy-pEifmlaZrhdTOM4uMX-gKoozRQONEcCd0tnsQ68CakoGRyd5DsaAp7-IWSjiNxw&_hsmi=15584116CMS will be penalizing over 2600 hospitals in 2015 for their hospital readmission rates, notwithstanding an overall reduction in readmissions, further pointing our how wrong-headed the initiative is.
http://www.modernhealthcare.com/article/20141002/NEWS/310029947&utm_source=AltURL&utm_medium=email&utm_campaign=mpdaily&AllowView=VXQ0UnpwZTRDdlNjL1IzSkUvSHRlRUtwajA0ZEErSmE=A study reported in JAMA finds that use of a “virtual ward” to prevent hospital readmissions was no more effective than usual care and a second article reviews the overall state of the research on readmission prevention.
A study in Health Affairs analyzes hospital admissions and Readmissions for patients covered by Medicaid.
Patients who reside in neighborhoods with low socioeconomic status have higher rates of hospital readmissions, even after adjusting for individual socioeconomic status and other factors, according to a study in the journal Circulation Outcomes, providing further evidence of how flawed CMS' readmission penalty program is.
http://circoutcomes.ahajournals.org/content/early/2014/07/29/CIRCOUTCOMES.113.000911.full.pdfA review of interventions to prevent hospital readmissions for heart failure diagnoses finds that certain types may be effective.
The use of administrative data, as opposed to chart review, to gather information on hospital readmissions, results in incorrect reasons for the readmission in about a third of cases, according to research in JAMA Surgery, which could seriously affect penalties levied on hospitals under the CMS program to reduce readmissions.
http://archsurg.jamanetwork.com/article.aspx?articleID=1879843&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=ArchivesofSurgery%3AOnlineFirst06%2F11%2F2014&utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=13177961&_hsenc=p2ANqtz-8sG6r4Nnjy-e8mks87DfEwo8tr35TLMGEXgl6jgnFuDaBUeZhFUYNaU2B-3FBJ27qRggrpfhg4l7FLl38FI8LYmPVWGg&_hsmi=13177961Two articles in Health Affairs examine the likelihood that by not incorporating socioeconomic factors, the Medicare readmission penalties are hurting hospitals that serve large numbers of low-income patients.
A Statistical Brief from the Agency for Healthcare Research & Quality examines hospital readmissions for the year 2011.
A study in the British Medical Journal following the health reform implementation in Massachusetts finds that providing insurance does not reduce 30-day hospital readmission rates.
A study in JAMA looks at hospital readmissions after discharge from inpatient rehabilitation units, finding an overall rate of around 12% for leading conditions with substantial variation across facilities and regions. Many of these patients appear to be in a downward cycle which is hard to interrupt.
http://jama.jamanetwork.com/article.aspx?articleid=1829684A study done by KNG Health Consulting for Academy Health finds that the Medicare hospital readmission penalties disproportionately affect hospitals servicing low income patients; the very hospitals that can least afford to lose resources.
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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