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High Readmission Rates May Not Mean Worse Hospital Care
Date:7/14/2010

By Karen Pallarito
HealthDay Reporter

WEDNESDAY, July 14 (HealthDay News) -- When patients are readmitted within 30 days of a hospital stay, it is generally considered a sign of poor quality care and wasteful spending on the hospital's part.

But in a new analysis involving heart failure patients, Cleveland Clinic researchers challenge that conventional wisdom. Their calculations suggest that being readmitted to the hospital after an inpatient stay for heart failure may not be such a bad thing, after all.

Keeping more patients alive for a month in the first place means there are more patients eligible for readmission, they reason. They also suspect that assuring appropriate care for these patients, including any necessary procedures or surgery, may necessitate readmission to the hospital -- which would drive up readmission rates.

"I think that the message to patients and the general public is that they should be wary of seemingly simple measures of quality of care," said Dr. Eiran Z. Gorodeski, a researcher and associate staff member in cardiovascular medicine at the Cleveland Clinic. "One simple measure is not enough."

The analysis is described in a letter signed by Gorodeski and his Cleveland Clinic colleagues Drs. Randall C. Starling and Eugene H. Blackstone. The letter appears in the July 15 issue of the New England Journal of Medicine.

Policymakers are zeroing in on hospital readmission rates as part of an ongoing quest to improve health-care quality and reduce costs.

The federal health reform law enacted in March includes a provision requiring the U.S. Secretary of Health and Human Services to track readmission rates for certain high-cost conditions, including heart failure. Beginning Oct. 1, 2012, Medicare payments to hospitals with high readmission rates will be reduced.

The government began posting those readmission rates on the Hospital Compare website last week (www.hos
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