Navigation Links
Can hospital readmission rates be trusted?
Date:2/15/2013

MAYWOOD, Il. - When hospital patients have to be readmitted soon after discharge, hospitals look bad.

A high readmission rate also can result in reduced Medicare reimbursements. But a study of spine surgery patients has found that the standard method used to calculate readmission rates is a misleading indicator of hospital quality. Loyola University Medical Center neurosurgeon Beejal Amin, MD, and colleagues found that 25 percent of the readmissions of spine surgery patients were not due to true quality-of-care issues.

Results are reported in a featured article in the February, 2013 issue of the Journal of Neurosurgery.

"We have identified potential pitfalls in the current calculation of readmission rates," Amin said. "We are working on modifying the algorithm to make it more clinically relevant."

Medicare is trying to improve patient care by penalizing hospitals with poor outcomes. One key outcomes measure is the readmissions rate. Medicare may begin to withhold reimbursements to hospitals with excessively high readmission rates.

In spine surgery, a high readmission rate can indeed reflect poorly on a hospital's quality of care if the readmissions are due to reasons such as infections, surgical complications, blood clots and failures of surgical hardware, Amin said.

But some types of readmissions are not a true indication of quality of care, Amin said. Such cases include:

  • Planned readmission for a staged procedure. For example, a procedure to straighten a curved spine in a scoliosis patient requires two surgeries performed in different stages.

  • Readmission unrelated to spine surgery. Occasionally, patients who undergo spine surgery will be readmitted within 30 days for surgery for an unrelated condition, such as a hip replacement.

  • Operation cancelled or rescheduled for unpreventable reasons. For example, a patient is admitted to the hospital but the spinal surgery is postponed due to an irregular heart rate. The patient is readmitted a couple weeks later for elective surgery, after the heart rhythm is controlled.

Amin and colleagues examined the records of 5,780 spine surgery patients treated at the University of California San Francisco Medical Center between October, 2007 and June, 2011. (Before joining Loyola, Amin did a clinical fellowship in complex spine surgery at UCSF under Dr. Praveen Mummaneni. Currently, Amin is an assistant professor in the Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine. His clinical expertise is in minimally invasive and complex spine surgery.)

The study found that, under the standard readmission formula, 281 patients were readmitted within 30 days of discharge. But 69 of these readmissions (25 percent) should not have been counted against the hospital. These included 39 cases that were planned readmissions for staged procedures, 16 cases that were unrelated to spine surgery and 14 cases that were cancelled or rescheduled due to unpreventable reasons.

"From the clinician's point of view, this 25 percent of readmission cases was appropriate and unavoidable," the authors wrote. "Efforts to curtail such readmissions would be unnecessary and potentially use resources that could be directed elsewhere."

Amin and colleagues concluded that their findings identify the potential pitfalls in the calculation of readmission rates from administrative data sets.

"Current algorithms overestimate clinically relevant readmission rates and cost," Amin and colleagues wrote. "This overestimated rate may then be used by payers (that is, Medicare) to deny payment for clinically unavoidable readmissions. Developing more sophisticated algorithms with spine surgeons' input will increase the reporting accuracy. Surgeons can play a vital role to help improve benchmarking and improve the value of health care provided."


'/>"/>

Contact: Jim Ritter
jritter@lumc.edu
708-216-2445
Loyola University Health System
Source:Eurekalert

Related medicine news :

1. Little-Known Respiratory Infection Sends Many Kids to Hospital
2. For Hospitals, Lowered Death Rates May Not Mean More Readmissions
3. In Hospitals, Daily Antiseptic Bath May Prevent Dangerous Infections
4. FHA Unveils Section 242/223(f) Acquisition and Refinancing Program for Hospitals
5. ASU, Phoenix Childrens Hospital expand biomedical research partnership
6. Kish Hospital’s Center for Joint Care Celebrates Two Years of Patient Care
7. The Wellness Corporation announces Stellaris Health Network will offer Wellness Work/Life Program (EAP) services to employees of its member hospitals
8. Lorraine McLaren Joins Leading FHA Hospital Lender, AMS Health Care Mortgage Corporation
9. 1 in 5 Hospital Docs Reports Unsafe Workloads: Study
10. BrainTrain Announces Cognitive Training Software Giveaway to Veterans Hospitals
11. Baptist Health System Announces Expansion for North Central Baptist Hospital
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping to ... app. The fitness app plans to fix the two major problems leading the fitness industry ... fits all type program , They don’t eliminate all the reasons people quit ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library ... City Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ... for fumigation is not a common occurrence, but a necessary one in the event that ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. ... from injury. Recently, he has implemented orthobiologic procedures as a method for treating ... one of the first doctors to perform the treatment. Orthobiologics are substances that ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Those who have ... these feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as ... Michigan, has released tools for healthy coping following a traumatic event. , Trauma sufferers ...
(Date:6/24/2016)... ... , ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys ... peers for this recognition are considered among the top 2 percent of lawyers practicing ... members of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Research and Markets has announced the addition ... to their offering. The ... commercial environment for MedImmune to enter. The US ageing population ... to drive considerable growth for effective anti-influenza medications. The introduction ... considerably, but development is still in its infancy. ...
(Date:6/23/2016)... and INDIANAPOLIS , June 23, 2016 ... Lilly Diabetes Tomorrow,s Leaders Scholarship is any indication, the ... announced today online at www.diabetesscholars.org by the ... diabetes stand in the way of academic and community ... Foundation,s scholarship program since 2012, and continues to advocate ...
(Date:6/23/2016)... June 23, 2016  Guerbet announced today that it ... Supplier Horizon Award . One of 12 ... recognized for its support of Premier members through exceptional ... excellence, and commitment to lower costs. ... recognition of our outstanding customer service from Premier," says ...
Breaking Medicine Technology: