A recent study published in Health Affairs suggests that a seven-day readmission interval may be a stronger indicator of quality care than the current measurement of thirty days. The study examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for patients ages sixty-five and older in four states.
“The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient. Similar patterns were seen across states and diagnoses.”
Researchers found that readmission rates were higher during the first few days after discharge and that the likelihood of readmission peaked at the seven day mark. This data could suggest that readmissions beyond the first seven days post-discharge are often related to risk factors outside of the hospital’s provided care.
Addressing the findings of the study, David L. Chin -a postdoctoral scholar at the Center for Healthcare Policy and Research at the University of California, Davis – and Patrick S. Romano – a professor of medicine and pediatrics at the University of California, Davis – have proposed three potential solutions.
- The thirty-day interval for capturing readmissions should be shortened and better tailored to the actual time course of preventable complications after each conditions or procedure.
- Begin using readmission rates less to measure a hospital’s quality and more a measure of resource use and performance of the health care systems. Reevaluate the weight given to readmission rates in hospitals five-star ratings.
- Federal policy should acknowledge that readmissions reflect many things that happen to patients post-discharge.
The data provided in the study showed that less than 3 percent of patient readmission risks were related to the differences in quality between the given hospitals. Chin and Romano noted that readmission rates were an important resource, but often a poor indicator of a hospital’s quality.