Heart failure is a major contributor to hospital readmission penalties

Andrija Vidic, John T. Chibnall, Paul Hauptman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background The Hospital Readmissions Reduction Program provides incentives to hospitals to reduce early readmissions for heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PNE). Methods and Results To examine the contribution of each diagnosis to readmissions penalty size, data were obtained from the Center for Medicare and Medicaid Services, American Hospital Association, and United States Census Bureau including number of cases; readmissions payment adjustment factor (values <1 indicate a penalty for excess readmissions), excess readmission ratio (ERR, or ratio of adjusted predicted readmission based on comorbidities, frailty, and individual patient demographics to expected probability of readmission at an average hospital) for each diagnosis, hospital teaching status, bed number, and zip code socioeconomic status. Of 2,228 hospitals with ≥25 cases per diagnosis, 1,636 received a penalty. Univariate correlation coefficients between penalty and ERR were -0.66, -0.61, and -0.43 for HF, PNE, and AMI, respectively (all P <.001). Correlation between ERRs was greatest for PNE and HF (0.30; P <.001) and weakest for PNE and AMI (0.12; P <.001). In regression analyses, the HF ERR explained the most variance in the penalty (R2 range 0.21-0.44). Conclusion HF ERR, not the number of cases, was related to penalty magnitude. These findings have implications for the design of hospital-based quality initiatives regarding readmissions.

Original languageEnglish (US)
Pages (from-to)134-137
Number of pages4
JournalJournal of Cardiac Failure
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

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Patient Readmission
Heart Failure
Pneumonia
Myocardial Infarction
American Hospital Association
Hospital Design and Construction
Social Adjustment
Centers for Medicare and Medicaid Services (U.S.)
Censuses
Social Class
Teaching Hospitals
Comorbidity
Motivation
Regression Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Heart failure is a major contributor to hospital readmission penalties. / Vidic, Andrija; Chibnall, John T.; Hauptman, Paul.

In: Journal of Cardiac Failure, Vol. 21, No. 2, 01.02.2015, p. 134-137.

Research output: Contribution to journalArticle

Vidic, Andrija ; Chibnall, John T. ; Hauptman, Paul. / Heart failure is a major contributor to hospital readmission penalties. In: Journal of Cardiac Failure. 2015 ; Vol. 21, No. 2. pp. 134-137.
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