AHRQ debuts national hospital readmission database

The Agency for Healthcare Research and Quality (AHRQ) has introduced a national database for hospital readmissions.

The Nationwide Readmissions Database (NRD) serves to analyze national hospital readmission rates and is the first all-payer nationwide database that supports tracking hospital readmissions. Researchers, public health professionals, administrators, policymakers and clinicians will be able to use the new database in their analyses and decision-making.

The NRD is part of the AHRQ-sponsored Healthcare Cost and Utilization Project (HCUP), a group of related databases that includes information from administrative billing data. 

The NRD is drawn from the HCUP State Inpatient Databases (SID) and can be used to create estimates of national readmission rates for all payers and the uninsured, according to information on its website. The 2013 NRD was constructed from 21 states with reliable, verified patient linkage numbers in the SID that could be used to track the patient across hospitals within a state, while adhering to strict privacy guidelines.

According to AHRQ, key features of the 2013 NRD include:

• A large sample size, which provides sufficient data for analysis across hospital types and the study of readmissions for relatively uncommon disorders and procedures.
• Discharge data from 21 geographically dispersed states, accounting for 49.3 percent of the total U.S. resident population and 49.1 percent of all U.S. hospitalizations.
• Designed to be flexible to various types of analyses of readmissions in the U.S. for all types of payers and the uninsured.
• Criteria to determine the relationship between multiple hospital admissions for an individual patient in a calendar year is left to the analyst using the NRD.
• Outcomes of interest include national readmission rates, reasons for returning to the hospital for care, and the hospital costs for discharges with and without readmissions.
• The NRD is designed to support national readmission analyses and cannot be used for regional, state-, or hospital-specific analyses.

A new HCUP Statistical Brief examines trends in hospital readmissions for four high-volume conditions: congestive heart failure, chronic obstructive pulmonary disease, heart attack and pneumonia. According to the brief, there were 500,000 readmissions totaling $6.8 bilion in aggregate hospital costs for the four conditions in 2013. 

HCUP databases include information on 97 percent of all U.S. hospital discharges.