Top hospitals reduce readmissions by preventing complications across all diagnoses

November 20, 2013

Checking back into the hospital within 30 days of discharge is not only bad news for patients, but also for hospitals, which now face financial penalties for high readmissions. The key to reducing readmissions may be focusing on the whole patient, rather than the specific conditions that caused their hospitalizations, according to a new study by Yale School of Medicine researchers.

Published Nov. 20 in the British Medical Journal, the researchers found that top-performing hospitals—those with the lowest 30-day —had fewer readmissions from all diagnoses and time periods after discharge than lower performing hospitals with higher readmissions.

"Our findings suggest that hospitals may best achieve low rates of readmission by employing strategies that lower readmission risk globally rather than for specific diagnoses or time periods after hospitalization," said lead author Kumar Dharmarajan, M.D., a visiting scholar at the Center for Outcomes Research and Evaluation at Yale School of Medicine and cardiology fellow at Columbia University Medical Center.

Despite the increased national focus on reducing readmissions, Dharmarajan said it had not been clear whether hospitals with the lowest readmission rates have been especially good at reducing readmissions from specific diagnoses and time periods after hospitalization, or have instead lowered readmissions more generally. To find out, Dharmarajan and colleagues studied over 4,000 hospitals in the United States caring for older patients hospitalized with heart attacks, heart failure, or pneumonia from 2007 through 2009. The authors examined over 600,000 readmissions occurring within 30 days of hospitalization.

The research team found that readmission diagnoses and timing were similar regardless of a hospital's 30-day readmission rates. High performing hospitals had fewer readmissions across all diagnostic categories and time periods after discharge. "Earlier data show that patients are readmitted for a broad range of conditions. We have found empirically that hospitals with the lowest readmission rates have reduced readmissions across the board," said Dharmarajan.

"This study suggests that the path to excellence in readmission is a result of an approach that focuses on the patient as a whole rather than on what caused them to be admitted," said senior author and director of the Yale Center for Outcomes Research and Evaluation Harlan Krumholz, M.D., the Harold H. Hines, Jr. Professor of Medicine and professor of investigative medicine and of public health at Yale School of Medicine. "And this study adds emphasis to the idea that patients are susceptible to a wide range of conditions after a hospitalization—they are a highly vulnerable population and we need to focus intently on making the immediate post-discharge period safer."

Explore further: Readmissions frequent in month after hospital discharge

Related Stories

Readmissions frequent in month after hospital discharge

January 22, 2013
Following hospitalization for heart attacks, heart failure, or pneumonia, patients are at high risk of being readmitted for a broad spectrum of medical conditions in the month following hospital discharge, research at Yale ...

Hospital readmission rates linked with quality of surgical care

September 18, 2013
Reducing hospital readmission rates is an important clinical and policy priority but whether those rates really measure the quality of hospital care isn't clear. In a new study, researchers from Harvard School of Public Health ...

Same-hospital readmission rate an unreliable predictor for all-hospital readmission rate

October 8, 2013
Approximately one in five Medicare patients are rehospitalized within 30 days of discharge.* The Centers for Medicare & Medicaid Services (CMS) considers this rate excessive, and began reducing payments to hospitals that ...

Pediatric readmission rates aren't indicator of hospital performance

August 26, 2013
Readmission rates of adult patients to the same hospital within 30 days are an area of national focus and a potential indicator of clinical failure and unnecessary expenditures.

Hospital readmission rates not accurate measure of care quality

August 22, 2011
Avoidable readmissions after discharge from hospital are fairly uncommon and are not an accurate measure of quality of care, found a study in CMAJ (Canadian Medical Association Journal).

Study finds readmission rates impacted by a patients' knowledge and skills

October 9, 2013
A study by physicians at Boston Medical Center (BMC), has found that patients with a high degree of activation (possessing the knowledge, skills, confidence and inclination to assume responsibility for managing one's health ...

Recommended for you

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.