Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Gupta, Shivani; Zengul, Ferhat; Davlyatov, Ganisher; Weech‐Maldonado, Robert

doi:10.1177/0046958018817994

Cited by 14 publications

(28 citation statements)

References 50 publications

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“…Given that both preoperative medical comorbidities and postoperative complications were associated with readmission, consideration of a greater length of stay in medically complex patients or in the setting of complications such as pneumonia and PCF should be considered. Furthermore, novel strategies for patients with PCF, such as hospital‐adjacent rehabilitation facilities or hospital‐based skilled nursing facilities to allow greater specialized care, may facilitate lowered readmission rates …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, novel strategies for patients with PCF, such as hospital-adjacent rehabilitation facilities or hospital-based skilled nursing facilities to allow greater specialized care, may facilitate lowered readmission rates. 18 Patients with an unplanned readmission within 30 days had a significantly longer time to start adjuvant therapy than those who were not readmitted. Of the patients that were readmitted that were recommended adjuvant therapy 75% had a delay in initiation of adjuvant therapy.…”

Section: Unplanned Readmission Ratementioning

confidence: 96%

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Risk factors for unplanned readmission in total laryngectomy patients

Vimawala

Topf²,

Savard

et al. 2019

The Laryngoscope

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Objective To determine which patient or surgical factors affect the likelihood of unplanned readmission (within 30 days) after total laryngectomy (TL). Methods Retrospective chart review of all patients who underwent TL at a single institution from April 2007 through August 2016. Primary outcome was unplanned readmission to the hospital within 30 days of discharge. Univariable and multivariable logistic regression were performed to identify risk factors for unplanned readmission. Results Two hundred seventy‐eight patients met inclusion criteria. Twenty‐nine patients (10.4%) had unplanned readmissions within 30 days. The most common reasons for readmission were pharyngocutaneous fistula (n = 15), neck abscess (n = 3), and wound breakdown (n = 4). Average time to unplanned readmission was 11.2 days (range 0–27 days). Fistula (OR 30.259; 95% CI, 9.186, 118.147; P ≤ .001), postoperative pneumonia (OR 9.491; 95% CI, 1.783, 53.015; P = .008), and history of cardiac disease (OR 7.074; 95% CI, 2.324, 25.088, P = .001) were independently associated with an increased risk of 30‐day unplanned readmission on multivariate analysis. However, return to OR on initial admission was associated with a lower risk of unplanned readmission (OR 0.075; 95% CI, 0.009, 0.402; P = .007). Unplanned readmission was associated with a delay in initiation of adjuvant radiation (OR 1.494; 95% CI, 1.397, 1.599; P < .001). Conclusion Unplanned readmission occurs in a small but significant number of TL patients. Patients who have a 30‐day unplanned readmission may be at risk for a delay in initiation of adjuvant therapy. Level of Evidence 4 Laryngoscope, 130:1725–1732, 2020

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Section: Discussionmentioning

confidence: 99%

Section: Unplanned Readmission Ratementioning

confidence: 96%

Risk factors for unplanned readmission in total laryngectomy patients

Vimawala

Topf²,

Savard

et al. 2019

The Laryngoscope

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“…Previous studies have utilized the AHA, HC, and AHRF datasets to study hospitals’ readmission rates. 17–19 The CMS CMI files contain CMIs for hospital discharges representing the hospitals’ average diagnosis-related group (DRG) relative weights. The RUCA codes use measures of population density, urbanization, and daily commuting to classify US census tracts.…”

Section: Methodsmentioning

confidence: 99%

Does Geographic Location Affect the Quality of Care? The Difference in Readmission Rates Between the Border and Non-Border Hospitals in Texas

Shin¹,

Ramamonjiarivelo²,

Medina³

2022

RMHP

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Purpose Previous literature has limited empirical evidence describing the association between border location and readmission rates among hospitals in the U.S.-Mexico border region. Thus, our study explores this novel connection in Texas border hospitals using a non-experimental longitudinal study design. Materials and Methods Using longitudinal panel data (2013~2016) drawn from the American Hospital Association Annual Survey Database, Hospital Compare, and Area Health Resource File, a random-effects linear regression analysis was performed to quantify the impact of border location on the readmission rates of the same sample at multiple timed points. Results We found a positive relationship between border location and 30-day hospital readmission rates for heart failure and pneumonia in Texas. Border hospitals in Texas had approximately a 4.17% higher heart failure readmission rate and a 3.46% higher pneumonia readmission rate than non-border hospitals. We also identified several hospital organizational and market factors associated (eg, registered nurse [RN]-to-patient ratio) with hospital readmission rates. Conclusion The results suggest that improving RN staffing levels can be the most feasible action to lower the readmission rates among border Texas hospitals. Decreasing readmission rates by increasing RN staffing levels would also help them avoid reimbursement reduction under the Hospital Readmission Reduction Program (HRRP) and enhance overall health in Texas border communities. Further, to improve border health in Texas, decision-makers in state and local governments must consider incentivizing border hospitals to improve RN staffing levels and modulating the market factors affecting hospital readmission rates that are mostly beyond the control of hospitals.

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“…Conversely, the penalties adversely affected the finances of safety-net hospitals caring for uninsured and low-income patients [6]. To reduce financial penalties, hospitals have invested in strategies to reduce readmissions; several programs, such as the Care Transitions Intervention [7], Project Re-Engineered Discharge [8], and Interventions to Reduce Acute Care Transfers [9], and certain measures, such as having a skilled nursing facility within the hospital [10], have reduced readmissions.…”

Section: Research Articlementioning

confidence: 99%

Assessment of COPD Overdiagnosis as an Important Factor in COPD Readmission

Pandey¹,

Ojha²

2021

austinjpulmrespirmed

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Introduction: The Hospital Readmission Reduction Program (HRRP) was established in 2012 to improve health care by linking payment to the quality of hospital care. Readmission is considered a hospital care quality measure. Under the program, hospitals are penalized for Chronic Obstructive Pulmonary Disease (COPD) readmission, which incentivizes improved care to avoid financial penalties. The effect of COPD overdiagnosis on COPD readmission has not been studied. Objective: The study aims to assess the effect of COPD overdiagnosis in outpatient and inpatient settings on hospital COPD readmissions. Methods: We conducted a retrospective study and examined outpatient and inpatient settings for COPD overdiagnosis. In the outpatient setting, we collected all COPD referrals to our clinic and reviewed charts to determine if those patients had COPD or an alternate diagnosis after our workup. We also studied 3-year inpatient data from January 2015 to March 2018 on hospital readmissions and extracted COPD readmissions. For patients seen by a pulmonary provider in our clinic, we studied patients’ pulmonary function test/ spirometry results and charts and determined if they had a true COPD diagnosis or an overdiagnosis. We also assessed the effect of COPD overdiagnosis on inflation of COPD readmission numbers. Results: Of patients referred to our clinic, 46% did not have COPD on our workup. Among inpatients, our results revealed that preventing COPD overdiagnosis could have reduced admissions attributable to COPD by 22.6%. Conclusion: Correct diagnosis using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria is an inexpensive way for hospitals to avoid readmission penalties.

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Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Cited by 14 publications

References 50 publications

Risk factors for unplanned readmission in total laryngectomy patients

Risk factors for unplanned readmission in total laryngectomy patients

Does Geographic Location Affect the Quality of Care? The Difference in Readmission Rates Between the Border and Non-Border Hospitals in Texas

Assessment of COPD Overdiagnosis as an Important Factor in COPD Readmission

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