Key result
Adjusting for additional clinical and social characteristics reduced the mean difference in 30-day readmission rates between top and bottom high-risk hospital quintiles by 0.53 points (P<.001).
Why the study?
Does adjusting for additional clinical and social patient characteristics change hospital performance on 30-day readmission rates compared to current Medicare adjustments?
Population
1,003,664 unique Medicare beneficiaries in 2,215 hospitals, mean age 79.9, 41.5% men.
Comparison
Adjustment for additional clinical and social… vs Adjustment for patient characteristics currently…
Design
Cohort
Follow-up
30 days
Authors
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May mitigate penalties for high-risk hospitals; leaves open whether Medicare adjustments should be revised.
Observational (n=1,003,664)
Yes
Does adjusting for additional clinical and social patient characteristics change hospital performance on 30-day readmission rates compared to current Medicare adjustments?
Mean Difference: 0.53 (95% CI 0.5–0.55)
p-value: p=<.001
Adjusting for social and additional clinical characteristics mitigates penalties for hospitals serving high-risk patients without holding them to different standards of care.
Roberts et al. (2018) conducted an observational in Hospital readmission (n=1,003,664). Adjustment for additional clinical and social patient characteristics vs. Adjustment for patient characteristics currently implemented by Medicare was evaluated on All-cause readmission within 30 days of discharge (MD 0.53 percentage points, 95% CI 0.50-0.55, p=<.001). Adjusting for additional clinical and social characteristics reduced the mean difference in 30-day readmission rates between top and bottom high-risk hospital quintiles by 0.53 points (P<.001).
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