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
Sign In
Advertise with Us
Sekisui Diagnostics UK Ltd.

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
STI Test
Vivalytic Sexually Transmitted Infection (STI) Array
Gold Member
Disposable Protective Suit For Medical Use
Disposable Protective Suit For Medical Use
Silver Member
Wireless Mobile ECG Recorder
Mechanical Baby Scale
seca 725

Print article


Surgical Techniques

view channel
Image: Miniaturized electric generators based on hydrogels for use in biomedical devices (Photo courtesy of HKU)

Hydrogel-Based Miniaturized Electric Generators to Power Biomedical Devices

The development of engineered devices that can harvest and convert the mechanical motion of the human body into electricity is essential for powering bioelectronic devices. This mechanoelectrical energy... Read more

Patient Care

view channel
Image: The newly-launched solution can transform operating room scheduling and boost utilization rates (Photo courtesy of Fujitsu)

Surgical Capacity Optimization Solution Helps Hospitals Boost OR Utilization

An innovative solution has the capability to transform surgical capacity utilization by targeting the root cause of surgical block time inefficiencies. Fujitsu Limited’s (Tokyo, Japan) Surgical Capacity... 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 Quantra Hemostasis System has received US FDA special 510(k) clearance for use with its Quantra QStat Cartridge (Photo courtesy of HemoSonics)

Critical Bleeding Management System to Help Hospitals Further Standardize Viscoelastic Testing

Surgical procedures are often accompanied by significant blood loss and the subsequent high likelihood of the need for allogeneic blood transfusions. These transfusions, while critical, are linked to various... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.