What question did this study set out to answer?

To evaluate trends in 30-day hospital revisits, including readmissions, observation stays, and emergency department visits, for medical conditions targeted by the Hospital Readmissions Reduction Program.

August 12, 2019BMJOpen Access

Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: national retrospective analysis

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Why the study?

Does the Hospital Readmissions Reduction Program affect total hospital revisits within 30 days of discharge?

Key Points

To evaluate trends in 30-day hospital revisits, including readmissions, observation stays, and emergency department visits, for medical conditions targeted by the Hospital Readmissions Reduction Program.
Conducted a national retrospective analysis of 30-day post-discharge acute care utilization in the United States.
Assessed changes in rates of inpatient readmissions, observation stays, and emergency department visits for conditions targeted by the Hospital Readmissions Reduction Program.
Total 30-day hospital revisits increased across the study period for targeted medical conditions.
The growth in post-discharge emergency department visits and observation stays exceeded the concurrent decline in inpatient readmissions.

Structured PICO

Does the Hospital Readmissions Reduction Program affect total hospital revisits within 30 days of discharge?

Population

Patients discharged for medical conditions targeted by the Hospital Readmissions Reduction Program (HRRP) in the United States

Intervention

Hospital Readmissions Reduction Program (HRRP) exposure/study period

Outcome

Total hospital revisits within 30 days of discharge (including readmissions, emergency department visits, and observation stays)

The apparent reduction in 30-day hospital readmissions under the HRRP may actually reflect a shift in care to emergency department visits and observation stays rather than a true decrease in post-discharge acute care utilization.

Discussion

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Implication

May indicate HRRP readmission declines mask shifts to ED and observation care; leaves open whether penalties reduce total post-discharge utilization.

Cite This Study

Wadhera et al. (2019) studied this question.

synapsesocial.com/papers/69d8f6892c87b79b92d18634 https://doi.org/10.1136/bmj.l4563

Topics

Heart failure HFrEF treatment

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Implication

May indicate HRRP readmission declines mask shifts to ED and observation care; leaves open whether penalties reduce total post-discharge utilization.

Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: national retrospective analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: national retrospective analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider