As one might expect, 30-day readmission rates refer to how many patients re-enter a given hospital’s care for any reason within 30 days of their original release. Usually, hospitals track this data for different kinds of patients depending on the hospital’s specialization (e.g. heart failure patients, heart attack patients, serious surgery, or pneumonia) as well as an overall 30-day readmission rate for the entire hospital. Hospitals track this data in order to help discern what aspects of their process, delivery of care, staffing, or general operation can be improved to help patients recover completely as a result of a single visit. These readmission rates are then adjusted for patients who have other conditions (comorbidities) that may make death or readmission more likely regardless of skilled care.
Many hospitals conduct large amounts of business with Medicare (a socialized healthcare distribution system designed to provide healthcare services to patients over the age of 65), particularly if the hospital is in an area with a high concentration of elderly citizens. A primary determinant of federal Medicare subsidies is a hospital’s 30-day readmission rate as well as its 30-day mortality rate. After measurement, individual hospital readmission rates are then compared to the U.S. national readmission rates. For example, if the entire estimated range of a hospitals 30-day readmission rates (both before and after adjustment for comorbidities) is below the U.S. national readmission rate, the hospital is deemed as performing above the U.S. national rate. If a hospital falls below the number of requisite measurable cases (usually 25, which may occur in many smaller hospitals) hospital readmission rates are unable to be measured correctly.
With the passage of the Affordable Care Act (also known as Obamacare) in 2010, hospitals are now facing additional incentive to lower their 30-day readmission rates. Those hospitals who are deemed poor-performing will forfeit 1-3 percent of their Medicare reimbursements through a financial penalization system that depends on how high their readmission rates are compared to the national rate. The Affordable Care Act has the potential to adversely affect the operation of smaller rural hospitals, as well as hospitals that primarily assist low-income families, as these hospitals tend to have smaller budgets than large healthcare providers with large labor pools and high capacity for advanced healthcare services.
Key strategies to reduce 30-day readmission rates include nurturing partnerships between physician groups and hospitals, awarding responsibility of medicine reconciliation to nurses, documenting follow-up examinations prior to discharge, and implementing the practice of sending all hospital patient treatment summaries to each patient’s primary care physician. Communication is absolutely essential: if physicians know how hospitals have been treating patients and vice versa, there is less potential for error at each juncture in the treatment process. Patients are therefore less likely to be readmitted, misdiagnosed, or treated ineffectively.