Should readmission rates be used to measure hospital quality? New study casts doubts

Hospitals with higher readmission rates are actually more likely to have lower mortality scores for patients treated for heart failure, chronic obstructive pulmonary disease and stroke, according to a new study published in the Journal of Hospital Medicine.

The study comes from a group of physicians and researchers with Johns Hopkins University in Baltimore. For the study, the group examined three years of CMS data on hospitals from across the United States. The group compared data on readmission rates and mortality rates across six conditions — heart attack, pneumonia, heart failure, stroke, COPD and coronary artery bypass — from nearly 4,500 acute care facilities.

Analysis revealed high rates of readmission were associated with better mortality scores for COPD, stroke and heart failure. The study's findings suggest quality measures used by CMS to save money and promote more efficient care may be problematic.

Daniel Brotman, MD, a professor of medicine at Johns Hopkins and the study's lead author, said he commends CMS for working to reduce the cost of healthcare, "But using readmission rates as a measure of hospital quality is inherently problematic. High readmission rates could stem from the legitimate need to care for chronically ill patients in high-intensity settings."

Dr. Brotman cited the CMS overall hospital quality star ratings as "particularly problematic," stating that giving readmissions and mortality equal weight when ranking for quality skews data against hospitals.

More articles on quality: 
When developing quality and safety policies, nurse input may be overlooked 
3 ways Connecticut hospitals are helping patients sleep better 
Communicating a low star rating: A playbook for 1-star hospitals

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