Readmission and Hospital Quality Under Prospective Payment System

ObjectivesTo determine whether implementation of a case-based payment system changed all-cause readmission rates in the 30 days following discharge after surgery, we analysed all surgical procedures performed in all hospitals in France before (2002–2004), during (2005–2008) and after (2009–2012) its implementation.SettingOur study is based on claims data for all surgical procedures performed in all acute care hospitals with >300 surgical admissions per year (740 hospitals) in France over 11 years (2002–2012; n=51.6 million admissions).InterventionsWe analysed all-cause 30-day readmission rates after surgery using a logistic regression model and an interrupted time series analysis.ResultsThe overall 30-day all-cause readmission rate following discharge after surgery increased from 8.8% to 10.0% (P<0.001) for the public sector and from 5.9% to 8.6% (P<0.001) for the private sector. Interrupted time series models revealed a significant linear increase in readmission rates over the study period in all types of hospitals. However, the implementation of case-based payment was only associated with a significant increase in rehospitalisation rates for private hospitals (P<0.001).ConclusionIn France, the increase in the readmission rate appears to be relatively steady in both the private and public sector but appears not to have been affected by the introduction of a case-based payment system after accounting for changes in care practices in the public sector.

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Did case-based payment influence surgical readmission rates in France? A retrospective study

Vuagnat

Yilmaz

Roussot

et al. 2018

BMJ Open

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Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS

et al. 2014

Self Cite

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The Impact of Bundled Payment Policy on Health Care Operations: Evidence From China

Fan,

Wang,

Xie

et al. 2018

SSRN Journal

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Readmission and Hospital Quality Under Prospective Payment System

Cited by 4 publications

References 23 publications

Did case-based payment influence surgical readmission rates in France? A retrospective study

Did case-based payment influence surgical readmission rates in France? A retrospective study

Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS

The Impact of Bundled Payment Policy on Health Care Operations: Evidence From China

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