Observational study assessing changes in timing of readmissions around postdischarge day 30 associated with the introduction of the Hospital Readmissions Reduction Program.

BMJ Quality & Safety
Ashwin S NathanAmol S Navathe

Abstract

The Hospital Readmissions Reduction Program (HRRP) initially penalised hospitals for excess readmission within 30 days of discharge for acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia (PNA) and was expanded in subsequent years to include readmissions for chronic obstructive pulmonary disease, elective total hip arthroplasty, total knee arthroplasty and coronary artery bypass graft surgery. We assessed whether HRRP was associated with delays in readmissions from immediately before the 30-day penalty threshold to just after it. We included Medicare fee-for-service beneficiaries discharged between 1 January 2007 and 31 October 2015. Readmissions were assessed until December 31, 2015. The study period was divided into three phases: January 2007 to March 2009 (pre-HRRP), April 2009 to September 2012 (implementation) and October 2012 to December 2015 (penalty). We estimated additional readmissions between postdischarge days 31-35 compared with days 26-30 using a negative binomial difference-in-differences model, comparing target HRRP versus non-HRRP conditions at the same hospital in the same month in the pre-HRRP and penalty phases. HRRP was not associated with a significant difference in AMI readmissi...Continue Reading

References

Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Jul 4, 2007·Journal of Clinical Epidemiology·Ewoudt M W van de GardeHubert G M Leufkens
Mar 30, 2012·The New England Journal of Medicine·Robert A BerensonNoah S Kalman
Apr 1, 2014·PloS One·Natalie McCormickJ Antonio Avina-Zubieta
Dec 10, 2014·JAMA : the Journal of the American Medical Association·Justin B Dimick, Andrew M Ryan
Feb 26, 2016·The New England Journal of Medicine·Rachael B ZuckermanArnold M Epstein
Jun 11, 2016·International Journal of Epidemiology·James Lopez BernalAntonio Gasparrini
Dec 27, 2016·Annals of Internal Medicine·Jason H WasfyRobert W Yeh
Jul 19, 2017·Journal of General Internal Medicine·Karen E Joynt MaddoxArnold M Epstein
May 24, 2018·European Journal of Heart Failure·Ankur Gupta, Gregg C Fonarow
Jul 13, 2019·Journal of the American College of Cardiology·Rohan KheraHarlan M Krumholz

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