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

art 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."


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

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