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Reductions in Readmission NOT Due to Increase in Obs Status

By William Martinez Moderator | 24 Feb, 2016

An important new study in the NEJM addresses a topic that has come up here a few times. The study assessed the correlation between changes in readmission rates and use of observation services after adoption of the Affordable Care Act in 2010. They analyzed data Medicare claims data from 3387 hospitals and did not find evidence that changes in observation status hospital stays accounted for the decrease in readmissions.

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Replies

 

William Martinez Moderator Replied at 11:21 PM, 26 Feb 2016

Great blog by Ashish Jha about this study that asks now that we know that use of obs status is not the reason readmissions are down, are patients better off?

Dr. Jha reminds us readmission rates measure utilization not patient outcome. He argues the bigger question is has the Affordable Care Act’s Hospital Readmissions Reduction Program improved the underlying quality of care? What has the focus of readmissions done, if anything, to hospital mortality and infection rate?

To use his analogy, if your loved one is admitted to the hospital with pneumonia what are the outcomes you care about? Where does readmission within 30 days fall on the list of things you care about most?

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Elizabeth Glaser Replied at 11:55 PM, 26 Feb 2016

While I am glad that this seems to be the case, I have to admit some residual skepticism . I cant read the paper now because of some pressing work but will in a few weeks and may get back to you at that time.

Best regards,
Elizabeth

William Martinez Moderator Replied at 11:38 AM, 29 Feb 2016

I think many folks were skeptical, myself included. Seems to be best evidence so far, welcome your thoughts when time allow and for others to chime in too. While some gaming of the system could have taken place, it is not evident on a systematic basis or enough to account for declines in readmissions based on the data that was analyzed in this study.

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.