Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
Approach to Improving Safety
Setting of Care
Readmissions are subject to nonpayment by Medicare, but their use as a marker of quality is controversial. Experts have also raised concerns about the use of in-hospital mortality as a quality measure. Utilizing data from the AHRQ Medicare Patient Safety Monitoring System and the Centers for Medicare and Medicaid Services, this secondary analysis examined the link between rates of adverse events and rates of readmissions and 30-day mortality for patients treated for acute myocardial infarction in 793 hospitals. Investigators found that hospitals with a greater aggregate rate of adverse events also had higher readmission and mortality rates among patients with acute myocardial infarctions. Although readmission rates and mortality ratios have been criticized as inaccurate measures of the quality of care, the authors conclude that readmission and mortality rates do in fact reflect the quality of care in hospitals. A PSNet interview discussed the intersection of readmissions and quality.