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PSNet: Patient Safety Network
Journal Article

Association of changing hospital readmission rates with mortality rates after hospital discharge.

Dharmarajan K, Wang Y, Lin Z, et al. JAMA. 2017;318:270-278.

Reducing hospital readmissions is a major patient safety priority. The Centers for Medicare and Medicaid Services policy of nonpayment for readmissions for certain conditions has decreased their incidence. However, the impact of this policy on 30-day postdischarge mortality remains unknown. Researchers conducted a retrospective study of Medicare fee-for-service patients admitted to hospitals with heart failure, acute myocardial infarction, or pneumonia from 2008 through 2014. They calculated monthly 30-day risk-adjusted readmission rates and 30-day risk-adjusted mortality rates for each condition at each hospital. They then examined the association between hospitals' monthly trends in 30-day readmissions and 30-day mortality after discharge for each condition. The authors found a weak but significant association between decreased 30-day readmissions and lower 30-day postdischarge mortality and conclude that efforts to reduce readmissions for the analyzed conditions do not lead to increased mortality. A previous WebM&M commentary discussed an incident involving a patient readmitted to the hospital after being discharged to a skilled nursing facility.