HRRP penalizes hospitals based largely on the patients they serve, study finds

Medicare patients admitted to hospitals with higher readmission rates are more likely to have characteristics associated with a higher probability of readmission, according to a study published online today by JAMA Internal Medicine. “This finding suggests that Medicare is penalizing hospitals to a large extent based on the patients they serve,” the study concludes. The authors found 22 patient characteristics that significantly predicted readmission when added to standard Hospital Readmissions Reduction Program adjustments of hospital readmission rates, and 17 of these were distributed differently between hospitals in the highest and lowest quintiles of publicly reported readmission rates. For example, patients admitted to the highest quartile had more chronic conditions, less education, fewer assets, worse self-reported health status, more depressive symptoms, worse cognition and physical functioning, and more difficulties with daily living activities. The difference in readmission risk between hospitals in the highest and lowest quintiles fell by 48% after adjusting for all patient characteristics assessed. For more on the study, see today’s AHASTAT blog post.