Hospital-level variation in readmissions for Medicare heart attack, heart failure and pneumonia patients rapidly declines in the first seven days after discharge, suggesting that most readmissions after seven days may be explained by community or household factors outside the hospitals’ control, according to a study reported today in Health Affairs. The study examined the risk of unplanned readmission for the three conditions in Medicare patients aged 65 and older in four states. While public reporting and payment programs have “embraced 30-day readmissions as an indicator of between hospital variation in the quality of care,” the authors conclude that “shorter intervals of seven or fewer days might improve the accuracy and equity of readmissions as a measure of hospital quality for public accountability.”