July 26, 2017
A recent study published in JAMA found that a reduction in hospital readmission rates for older adults with three common medical conditions occurred without causing an increase in mortality rates.
Researchers Kumar Dharmarajan, MD, (Yale School of Medicine, New Haven, CT) and colleagues conducting the study examined whether hospital readmission reductions associated with the Affordable Care Act may have contributed to increased mortality after hospitalization.
Participants in the retrospective study included Medicare fee-for-service beneficiaries, aged 65 years or older who had been hospitalized with heart failure, acute myocardial infarction, or pneumonia from January 1, 2008 through December 31, 2014.
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Authors calculated 30-day risk-adjusted readmission rates (RARRs) and 30-day risk-adjusted mortality rates (RAMRs) after discharge for each condition in each month at each hospital from 2008 through 2014. The team reviewed the data for different time periods within the study period and at hospitals where readmission rates were high, average, or low (doi:10.1001/jama.2017.8444).
After analyzing the data for monthly trends, authors found a small but positive correlation between reduced readmissions and reduced death rates for the three conditions: “We can say that readmission reductions did not result in increased mortality. If anything, they may have decreased mortality,” said Dr Dharmarajan (Science Daily. July 18, 2017).
In addition, researchers found that the association between reduced readmissions and reduced mortality was stronger at 90 days compared with 30 days after hospital discharge.
Dr Dharmarajan and colleagues speculate that these findings may be due to improved hospital and post-hospital care strategies—such as better preparing patients/families for discharge, more timely follow-ups, and better communications with outpatient providers—brought about by the national focus on reducing readmissions and improving outcomes.—Amanda Del Signore