December 1, 2014Annals of Internal Medicine
Considering the Role of Socioeconomic Status in Hospital Outcomes Measures
Design
Editorial
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Overview
Hospitals serving disadvantaged populations risk unfair penalties from unadjusted metrics; this extends debate on equitable quality measurement and policy.
Key Points
- To examine whether and how socioeconomic status should be incorporated into risk-standardized hospital readmission outcome measures used for quality assessment and benchmarking.
- Review and synthesis of quality-measurement development for the Centers for Medicare & Medicaid Services based on administrative claims data.
- Evaluation of claims-based 30-day all-cause readmission models validated against medical record data across conditions including acute myocardial infarction and heart failure.
- National 30-day post-discharge readmission rates remain high for common cardiovascular conditions such as acute myocardial infarction and heart failure.
- Debate persists regarding whether adjusting performance measures for patient sociodemographic factors appropriately accounts for community disadvantage or unintentionally excuses disparities in clinical care.
Cite This Study
Krumholz et al. (2014) studied this question.