Study: Hospital readmission rates misleading

There are potential pitfalls of calculating hospital readmission rates solely based on nonvalidated administrative datasets, according to an article published in the April issue of Neurosurgery.

Beejal Y. Amin, MD, from University of California San Francisco, and colleagues sought to assess the accuracy of administrative datasets and identify independent predicators of readmission.

The team abstacted 5,854 consecutive spine admissions to UCSF Medical Center from July 2007 to June 2011 from the University HealthSystem Consortium using the clinical database/resource manager.

Of these admissions, 320 cases were rehospitalized within 30 days of the initial discharge date. The main reasons for readmission were infection (46.1 percent), planned, staged surgery (11.6 percent) and nonoperative management (9.8. percent).

Based on the researchers' chart review, 50 cases of the 320 were misclassified and 37 cases were planned, staged procedures and 13 cases (4.1 percent) were unrelated to the initial admission. “When planned, staged readmission cases are excluded, the total cost of readmission is reduced by 18.2 percent. The cost variance is in excess of one million dollars,” they wrote.

“Benchmarking algorithms for defining a hospital’s readmission rate must take into account planned, staged surgery and eliminate unrelated reasons for readmissions,” the authors concluded. “Current tools overestimate the true readmission rate and cost.”