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30-Day Readmission Rate—A Blunt Instrument That Needs Honing

Alexander C. Schwed, MD1; Christian de Virgilio, MD1
[+] Author Affiliations
1Department of Surgery, Harbor–University of California, Los Angeles Medical Center, Torrance
JAMA Surg. 2016;151(9):861. doi:10.1001/jamasurg.2016.1229.
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Estimated to cost Medicare $17 billion annually, hospital readmissions represent a potential cost-savings target. Unplanned readmissions may also measure hospital and medical quality because these events are presumed to demonstrate a gap in sound clinical care or discharge planning. To address this issue, the Centers for Medicare and Medicaid Services established the Medicare Hospital Readmissions Reduction Program to decrease readmissions and publicly report 30-day readmission rates for selected admission diagnoses and procedures.1 The number of reportable surgical conditions is expected to increase in the future.2 The Centers for Medicare and Medicaid Services has also begun penalizing hospitals with a higher than expected 30-day readmission rate. This program and these penalties rely on the assumption that 30-day readmissions indicate hospital and surgical quality.

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