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Hospital readmission rates not an accurate measure of care quality, study finds

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Avoidable readmissions after discharge are fairly uncommon and are not an accurate measure of quality care, according to a study published in the Canadian Medical Association Journal.

Carl van Walraven, MD, and his fellow researchers performed a prospective cohort study of urgent readmissions data from 11 teaching and community hospitals from October 2002 to July 2006. Patient data was taken into account if their readmission occurred within 6 months of discharge. Readmission summaries were reviewed to determine if an adverse event — defined in the study as a poor clinical outcome as a result of medical care — was at the root of readmission, and if that adverse event could have been avoided.

According to the study results, 649 of the 4,812 patients included in the study were reported as having an urgent readmission within 6 months of discharge — with 104 (16%) patients’ readmissions being potentially avoidable. Although readmission rates between hospitals varied significantly — from 7.5% to 22.5% — hospitals did not vary significantly by avoidable readmission rates.

“The proportion of patients who had an urgent readmission was not associated with the proportion of patients who had an avoidable readmission,” the authors wrote.

The findings, according to a Canadian Medical Association Journal press release, indicate that measures to reduce readmissions must be multifaceted and tailored to specific situations. The authors concluded that urgent readmission rates should be used with caution as a measure of quality hospital care.

“Urgent readmissions deemed potentially avoidable were relatively uncommon, comprising less than 20% of all urgent readmissions following hospital discharge,” the authors wrote. “Hospital-specific proportions of patients who were readmitted were not related to proportions with a potentially avoidable readmission.”

Reference:

• Van Walraven C, Jennings A, Taljaard M, et al. Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions. Can Med Assoc J. 2011. DOI:10.1503/cmaj.110400.

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