Thursday, March 28, 2024
Hawai'i Free Press

Current Articles | Archives

Friday, May 25, 2012
Hospitals to Lose Funding Over High Readmission Rates
By NCPA @ 5:31 PM :: 5100 Views :: National News, Ethics

Thirty-Day Readmissions: Truth and Consequences

From NCPA

Reducing hospital readmission rates has captured the imagination of U.S. policymakers because readmissions are common and costly, and at least in theory, a reasonable fraction of readmissions should be preventable, say researchers Karen E. Joynt and Ashish K. Jha.

To harness the potential savings of reducing readmissions, the Patient Protection and Affordable Care Act directed the Centers for Medicare and Medicaid Services to penalize hospitals with "worse than expected" 30-day readmission rates, thereby encouraging them to invest resources in lowering these rates.

However, according to the researchers, this policy focus is damaging and misguided, and unlikely to yield results that Congress is searching for.

  • It is unclear whether readmissions always reflect poor quality -- having a low mortality rate or a close relationship with the community can raise readmission rates.
  • Also, because hospitals are expending so much energy on reducing readmissions, they have probably forgone quality-improvement efforts related to more urgent issues, such as patient safety.
  • The metric itself is problematic: only a small proportion of readmissions at 30 days after initial discharge are probably preventable, as the primary drivers of readmission rates are outside the control of the hospital.

This last point is perhaps the most crucial, as studies have consistently shown that much of the efforts that are put into reducing readmissions will prove unfruitful.

  • A recent systematic review reported that on average just 27 percent of readmissions were preventable.
  • Moreover, only 12 percent were deemed preventable in studies that used clinical data.
  • Another study showed that although the total number of readmissions varied substantially among hospitals, the rate of preventable readmissions did not, suggesting that it was cause by factors beyond the hospitals' control.

Indeed, the growing body of evidence suggests that the primary drivers of variability in 30-day readmission rates are the composition of a hospital's patient population and the resources of the community in which it is located. Some of the most important drivers of readmissions are mental illness, poor social support and poverty, and these are factors most hospitals cannot change.

Source: Karen E. Joynt and Ashish K. Jha, "Thirty-Day Readmissions -- Truth and Consequences," New England Journal of Medicine, March 28, 2012.

 

Links

TEXT "follow HawaiiFreePress" to 40404

Register to Vote

2aHawaii

808 Silent Majority

Aloha Pregnancy Care Center

AntiPlanner

Antonio Gramsci Reading List

A Place for Women in Waipio

Ballotpedia Hawaii

Broken Trust

Build More Hawaiian Homes Working Group

Christian Homeschoolers of Hawaii

Cliff Slater's Second Opinion

DVids Hawaii

FIRE

Fix Oahu!

Frontline: The Fixers

Genetic Literacy Project

Grassroot Institute

Habele.org

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii ConCon Info

Hawaii Debt Clock

Hawaii Defense Foundation

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federalist Society

Hawaii Federation of Republican Women

Hawaii History Blog

Hawaii Homeschool Association

Hawaii Jihadi Trial

Hawaii Legal News

Hawaii Legal Short-Term Rental Alliance

Hawaii Matters

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Shippers Council

Hawaii Smokers Alliance

Hawaii State Data Lab

Hawaii Together

HIEC.Coop

HiFiCo

Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Moms for Liberty

Honolulu Navy League

Honolulu Traffic

House Minority Blog

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

Investigative Project on Terrorism

July 4 in Hawaii

Kakaako Cares

Keep Hawaii's Heroes

Land and Power in Hawaii

Legislative Committee Analysis Tool

Lessons in Firearm Education

Lingle Years

Managed Care Matters -- Hawaii

Malama Pregnancy Center of Maui

MentalIllnessPolicy.org

Military Home Educators' Network Oahu

Missile Defense Advocacy

MIS Veterans Hawaii

NAMI Hawaii

Natatorium.org

National Christian Foundation Hawaii

National Parents Org Hawaii

NFIB Hawaii News

No GMO Means No Aloha

Not Dead Yet, Hawaii

NRA-ILA Hawaii

Oahu Alternative Transport

Obookiah

OHA Lies

Opt Out Today

OurFutureHawaii.com

Patients Rights Council Hawaii

PEACE Hawaii

People vs Machine

Practical Policy Institute of Hawaii

Pritchett Cartoons

Pro-GMO Hawaii

P.U.E.O.

RailRipoff.com

Rental by Owner Awareness Assn

ReRoute the Rail

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

Robotics Organizing Committee

School Choice in Hawaii

SenatorFong.com

Sink the Jones Act

Statehood for Guam

Talking Tax

Tax Foundation of Hawaii

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

UCC Truths

US Tax Foundation Hawaii Info

VAREP Honolulu

Waagey.org

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii

Yes2TMT