We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
ARAB HEALTH - INFORMA

Download Mobile App




U.S. Federal Readmission Fines Linked to Higher Mortality

By HospiMedica International staff writers
Posted on 21 Nov 2017
Print article
A new study suggests that the U.S. Hospital Readmission Reduction Program (HRRP) may be so focused on avoiding readmissions that heart failure (HF) related death rates are increasing.

Researchers at Harvard Medical School (HMS; Boston, MA, USA), the University of California, Los Angeles (UCLA; USA), and other institutions conducted a study to examine the association of the HRRP with readmission and mortality outcomes among 115,245 Medicare patients hospitalized with HF between January 2006 and December 2014 in 416 U.S. hospitals. Time intervals related to HRRP were examined before implementation (March 31, 2010), during HRRP implementation, and after penalties went into effect (October 1, 2012). Main outcomes and measures were 30-day and one year all-cause readmission and mortality rates.

The results showed that 30-day risk-adjusted readmission rate declined from 20% before HRRP implementation to 18.4% in the HRRP penalties phase. In contrast, 30-day risk-adjusted mortality rate increased from 7.2% before HRRP implementation to 8.6% in the HRRP penalties phase. One year risk-adjusted readmission and mortality rates followed a similar pattern; risk-adjusted readmission rate declined from 57.2% to 56.3%, and risk-adjusted mortality rate increased from 31.3% to 36.3% after HRRP implementation. The study was published on November 12, 2017, in JAMA Cardiology.

“To avoid the penalties, hospitals now have incentives to keep patients out of hospitals longer, possibly even if previously some of these patients would have been readmitted earlier for clinical reasons,” said lead author Ankur Gupta, PhD, a cardiovascular researcher at Harvard Medical School. “Therefore, this policy of reducing readmissions is aimed at reducing utilization for hospitals, rather than having a direct focus on improving quality of patient care and outcomes.”

“Medicare financially penalizes approximately two-thirds of U.S. hospitals, based on their 30-day readmission rates,” said senior author Professor Gregg Fonarow, MD, co-chief of cardiology at UCLA. “This data suggests it also incentivized strategies that unintentionally harmed patients with heart failure. The policy should focus on incentivizing improving quality and patient-centered outcomes of those with heart failure, and not on a misguided utilization metric of re-hospitalizations.”

The HRRP was introduced by Medicare (Baltimore, MD, USA) in order to improve patient care by penalizing hospitals with poor outcomes. One key outcome measure is the readmission rate; one possible result is that Medicare may begin to withhold reimbursements to hospitals with excessively high readmission rates.

Related Links:
Harvard Medical School
University of California, Los Angeles

Gold Member
POC Blood Gas Analyzer
Stat Profile Prime Plus
Gold Member
12-Channel ECG
CM1200B
New
Blanket Warming Cabinet
EC250
New
Mattress Replacement System
Carilex DualPlus

Print article

Channels

Critical Care

view channel
Image: Changes in immune cells can predict patient recovery following out-of-hospital cardiac arrest (Photo courtesy of Adobe Stock)

Activating T Cells Could Improve Neurological Outcomes After Cardiac Arrest

Despite advancements in cardiopulmonary resuscitation (CPR) and improved hospital access, survival rates after out-of-hospital cardiac arrest (OHCA) remain low, with only about 10% of patients surviving.... Read more

Surgical Techniques

view channel
Image: (Left) An image of a 3D-printed material implanted in vivo for 4 weeks. (Right) A photo of coral (Photo courtesy of Dr Zhidao Xia and Jesus Cobaleda)

Revolutionary Coral-Inspired Material for Bone Repair Promotes Faster Healing

Bone defects caused by fractures, tumors, and non-healing injuries are major contributors to disability worldwide. Traditionally, doctors have used either a patient’s own bone (autograft) or donor bone... Read more

Patient Care

view channel
Image: The portable biosensor platform uses printed electrochemical sensors for the rapid, selective detection of Staphylococcus aureus (Photo courtesy of AIMPLAS)

Portable Biosensor Platform to Reduce Hospital-Acquired Infections

Approximately 4 million patients in the European Union acquire healthcare-associated infections (HAIs) or nosocomial infections each year, with around 37,000 deaths directly resulting from these infections,... Read more

Health IT

view channel
Image: First ever institution-specific model provides significant performance advantage over current population-derived models (Photo courtesy of Mount Sinai)

Machine Learning Model Improves Mortality Risk Prediction for Cardiac Surgery Patients

Machine learning algorithms have been deployed to create predictive models in various medical fields, with some demonstrating improved outcomes compared to their standard-of-care counterparts.... Read more

Point of Care

view channel
Image: The acoustic pipette uses sound waves to test for biomarkers in blood (Photo courtesy of Patrick Campbell/CU Boulder)

Handheld, Sound-Based Diagnostic System Delivers Bedside Blood Test Results in An Hour

Patients who go to a doctor for a blood test often have to contend with a needle and syringe, followed by a long wait—sometimes hours or even days—for lab results. Scientists have been working hard to... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.