Patient-related risk factors appear to be the primary driver of readmissions in hospitals serving a higher proportion of minority patients, according to a study published online yesterday by the journal Surgery. The researchers examined outcomes and patient factors in more than 168,000 colorectal surgery patients treated in 374 California hospitals from 2004-2011, including 47 hospitals with a high percentage of minority patients (63%) compared with the other hospitals (17%). They found that patient factors (such as race, low income and insurance status) accounted for up to 65% of the increased odds for readmission at the minority-serving hospitals, while hospital-level factors (such as procedure volume and type) accounted for up to 40%. The Centers for Medicare & Medicaid Services’ Hospital Readmissions Reduction Program penalizes hospitals for higher-than-expected readmission rates for certain conditions, the authors note. “These findings suggest that CMS should account for patient socio-economic factors when they compare readmission rates,” said Waddah Al-Refaie, M.D., the study’s senior investigator and chief of surgical oncology at MedStar Georgetown University Hospital in Washington, D.C.

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