The county in which a hospital was located explained 58% of the national variation in 30-day hospital readmission rates, with access to care showing the strongest association.
Observational (n=4,073)
Yes
Do community factors explain variation in 30-day hospital readmission rates for patients with AMI, HF, or pneumonia?
Community factors, particularly access to care, explain a substantial amount of variation in hospital readmission rates for AMI, HF, and pneumonia.
OBJECTIVE: To examine the relationship between community factors and hospital readmission rates. DATA SOURCES/STUDY SETTING: We examined all hospitals with publicly reported 30-day readmission rates for patients discharged during July 1, 2007, to June 30, 2010, with acute myocardial infarction (AMI), heart failure (HF), or pneumonia (PN). We linked these to publicly available county data from the Area Resource File, the Census, Nursing Home Compare, and the Neilsen PopFacts datasets. STUDY DESIGN: We used hierarchical linear models to assess the effect of county demographic, access to care, and nursing home quality characteristics on the pooled 30-day risk-standardized readmission rate. DATA COLLECTION/EXTRACTION METHODS: Not applicable. PRINCIPAL FINDINGS: The study sample included 4,073 hospitals. Fifty-eight percent of national variation in hospital readmission rates was explained by the county in which the hospital was located. In multivariable analysis, a number of county characteristics were found to be independently associated with higher readmission rates, the strongest associations being for measures of access to care. These county characteristics explained almost half of the total variation across counties. CONCLUSIONS: Community factors, as measured by county characteristics, explain a substantial amount of variation in hospital readmission rates.
Herrin et al. (Wed,) conducted a observational in Acute myocardial infarction, heart failure, or pneumonia (n=4,073). Community factors (county characteristics) was evaluated on Pooled 30-day risk-standardized readmission rate. The county in which a hospital was located explained 58% of the national variation in 30-day hospital readmission rates, with access to care showing the strongest association.
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