Recent article in Health Affairs attempts to account the factors that influence differences in readmission rates between safety net hospitals and other hospital. It uses a series of regression models to adjust for one factor at time that may affect readmissions. It concludes that while some of the difference is attributed to patient factors like poverty and lack of social supports, however some difference is still unexplained and likely represents differences in quality of care.
In their Incidental Economist post, researchers at Harvard School of Public Health point out methodological issues with the new study that may have affected the results.
The study comes on the heals of CMS new initiative to on Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries. The new CMS initiative acknowledges some of the problems with their hospital readmissions reduction program (HRRP) that penalizes hospitals with higher readmissions without adjusting for important social determinants.
CMS is suggesting hospitals develop interventions to prevent readmissions, especially in vulnerable, minority populations, through:
(a) creating systems responsive to the needs of diverse populations;
(b) ensuring patients have the social supports that they need to manage their condition; and
(c) addressing the social determinants that put them at continued and repetitive risk for readmission.
What do folks think? Is this realistic for hospitals to do? how?
Link leads to: http://content.healthaffairs.org/content/35/1/124.short
Link leads to: http://theincidentaleconomist.com/wordpress/readmissions-revisited/
Link leads to: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf