HealthDay News – For patients with myocardial infarction (MI), heart failure, and pneumonia, the Centers for Medicare & Medicaid Services (CMS) public reporting of hospital readmission rates has had no impact on 30-day readmission trends, according to a study published in the Journal of the American College of Cardiology.1

Adam D. DeVore, MD,  from the Duke Clinical Research Institute in Durham, N.C., and colleagues analyzed Medicare claims data from 2006 to 2012 for patients discharged after hospitalization for MI, heart failure, or pneumonia.

Data were included from >4,100 hospitals for 37,829 hospitalizations for MI, 100,189 for heart failure, and 79,076 for pneumonia. The researchers found that there were improvements in adjusted readmission rates for MI (−2.3%), heart failure (−1.8 percent), and pneumonia (−2.0%) when considering only recent trends (since 2009). When comparing trends before with those after reporting, there was no difference for MI, heart failure, or pneumonia (P = 0.72, 0.19, and 0.21, respectively). No changes were seen in 30-day post-discharge care for MI or pneumonia; for heart failure there were deceases in emergency department visits and for observation stays (P = 0.007 and 0.04, respectively).


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“In this analysis of Medicare claims data, we found no association between the 2009 CMS policy decision to report hospital readmission rates and changes in trends for readmission rates publicly,” the authors write.

Several authors disclose financial ties to the biopharmaceutical industry.

Summary and Clinical Applicability

The effects of the CMS mandated public reporting of hospital readmission rates were examined in this study, and no change was found in 30-day readmission rates for patients with MI, HF, or pneumonia.  CMS uses readmission rates to categorize hospitals into categories, comparing them to average national rates of hospital readmission, and assigning them performance grades such as “No Different than National Rate”, “Better than National Rate”, or “Worse than National Rate”.2

Readmission rates are important to consider as a means to assess the quality of care received during an inpatient hospitalization. Hospitals have the responsibility of ensuring that patients are adequately ready for discharge, after implementing measures such as proper medication reconciliation and ensuring adequate outpatient followup. 

Reference

1. Devore AD, Hammill BG, hardy NC, et al. Has Public Reporting of Hospital Readmission Rates Affected Patient Outcomes? J Am Coll Cardiol. 2016;67(8):963-972

2. Hospital Compare: 30-day Unplanned Readmission and Death Measures. Medicare.gov The Official U.S. Government Site for Medicare. Accessed February 24, 2016. Source code: https://www.medicare.gov/hospitalcompare/Data/30-day-measures.html