Further Evidence on the System-Wide Effects of the Hospital Readmissions Reduction Program
| Autor: | Lane Koenig, Fang He, Berna Demiralp |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Gerontology
medicine.medical_specialty Myocardial Infarction Health Care Utilization and Cost 030204 cardiovascular system & hematology Medicare Logistic regression Patient Readmission California Interrupted Time Series Analysis Insurance Claim Review 03 medical and health sciences 0302 clinical medicine Claims data medicine Unplanned readmission Humans 030212 general & internal medicine Quality Indicators Health Care Heart Failure Insurance Health business.industry Health Policy Interrupted time series Cardiorespiratory fitness Pneumonia United States Logistic Models Emergency medicine Florida business |
| Zdroj: | Health Services Research. 53:1478-1497 |
| ISSN: | 0017-9124 |
| DOI: | 10.1111/1475-6773.12701 |
| Popis: | Objective To investigate the potential spillover effects of the Hospital Readmissions Reduction Program (HRRP) on readmissions for nontargeted conditions and patient populations. We examine HRRP effects on nontargeted conditions separately and on non-Medicare populations in Florida and California. Data Sources From 2007–2013, 100 percent Medicare inpatient claims data, 2007–2013 State Inpatient Database (SID) for Florida, and 2007–2011 SID for California. Study Design We conducted an interrupted time series analysis to estimate the change in 30-day all-cause unplanned readmission trends after the start of HRRP using logistic regression. Principal Findings Hospitals with the largest reductions in targeted Medicare readmissions experienced higher reductions in nontargeted Medicare readmissions. Among nontargeted conditions, reductions were higher for neurology and surgery conditions than for the cardiovascular and cardiorespiratory conditions, which are clinically similar to the targeted conditions. For non-Medicare patients, readmission trends for targeted conditions in Florida and California did not change after HRRP. Conclusions Our findings are consistent with positive spillover benefits associated with HRRP. The extent of these benefits, however, varies across condition and patient groups. The observed patterns suggest a complex response, including a role of nonfinancial factors, in driving lower readmissions. |
| Databáze: | OpenAIRE |
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