Hospital readmission performance and patterns of readmission скачать в хорошем качестве

Hospital readmission performance and patterns of readmission

Read the full research online: http://www.bmj.com/content/347/bmj.f6571 Little is known about the relation between hospital rates of readmission and the diagnoses and timing of readmissions. For example, do high performing hospitals with the lowest 30 day readmission rates have fewer readmissions due to the same conditions that prompted the initial admission or that occur soon after discharge? If so, readmissions for recurrent illnesses should be less common and the median time to readmission longer at these institutions. In contrast, do high performing hospitals have broadly reduced risk of readmission for the spectrum of conditions necessitating readmission and is this risk of readmission lower for the entire month after discharge? In this case, both the distribution of readmission diagnoses and the median time to readmission should be similar to those of lower performing hospitals even though the absolute number of readmissions is less. Given uncertainties about which strategies are most effective in reducing readmissions in the context of contemporary practice, answers to these questions might illuminate how readmissions have been empirically reduced at hospitals with the lowest rates. In this study, Kumar Dharmarajan and colleagues set out to determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions.