January 19, 2018The Medicine ForumOpen Access

Readmission rates in not-for-profit vs. proprietary hospitals before and after the hospital readmission reduction program implementation

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Why the study?

Does the Hospital Readmission Reduction Program reduce 30-day readmission rates differently in not-for-profit versus proprietary hospitals?

Structured PICO

Does the Hospital Readmission Reduction Program reduce 30-day readmission rates differently in not-for-profit versus proprietary hospitals?

Population

2,491 US hospitals (1,908 not-for-profit, 583 proprietary) treating Medicare patients.

Intervention

Hospital Readmission Reduction Program (HRRP) implementation (evaluated in 2012).

Comparator

Pre-HRRP implementation period (2010).

Outcome

30-day all-cause Medicare readmission rate.

Likelihood of omitted variables such as patient factors and other hospital characteristics
Reliance on the parallel trends assumption for difference-in-differences analysis
Data limitations requiring hospitals to have readmission rates for both 2010 and 2012
Small sample size of hospitals without emergency departments
Potential misclassification of hospital ownership status

No takes yet. Share an insight, caveat, or question.

HRRP readmission reductions were similar across ownership types; leaves open whether other hospital factors modify program effects.

Birmingham et al. (2018) studied this question.

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