TrendLens December 7, 2017: Data Defining Readmissions Prior To 30-Days

Lisa Remington

Welcome to TrendLens…trends bending the curve in home health and post-acute care. In this issue of TrendLens, we focus on readmission data at 7-days and 30-days. Is 30-days the best analysis for readmissions? Does data for specific medical conditions tell us different information about 30-day readmissions? We provide insights for you to explore your own data. 

Lisa Remington, President, Remington Health Strategy Group

A recent study of  66,741,340 hospital discharge records examined risk-standardized 30-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The states: Arizona, California, Florida, and New York.

Four Key Findings About Readmissions:

  1. Hospital-level readmissions were low at the 30-day cutoff.
  2. Readmissions were higher within the first several days after discharge reaching the lowest point around seven days. This suggest that a five-to-seven-day interval would better capture hospital-attributable readmissions, particularly when compared to intervals of 30, 60, or 90 days.
  3. The hospital quality signal is higher in the first five days after discharge than at longer time periods, such as 30-days. This suggests that hospitals’ practices with respect to care coordination and post-discharge follow-up could have the greatest impact within the first few days after discharge.

The optimal interval for capturing hospital-level variation in the risk of readmission appears to vary across conditions. For example, the acute myocardial infarction patients had the greatest increase in hospital-level variation after the tenth post-discharge day.