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Assessing preventability in the quest to reduce hospital readmissions
Author(s) -
Lavenberg Julia G.,
Leas Brian,
Umscheid Craig A.,
Williams Kendal,
Goldmann David R.,
Kripalani Sunil
Publication year - 2014
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2226
Subject(s) - medicaid , medicine , metric (unit) , hospital readmission , hospital medicine , medline , medical emergency , value based purchasing , intensive care medicine , emergency medicine , health care , family medicine , operations management , payment , finance , business , political science , law , economics , economic growth
Hospitals devote significant human and capital resources to eliminate hospital readmissions, prompted most recently by the Centers for Medicare and Medicaid Services (CMS) financial penalties for higher‐than‐expected readmission rates. Implicit in these efforts are assumptions that a significant proportion of readmissions are preventable, and preventable readmissions can be identified. Yet, no consensus exists in the literature regarding methods to determine which readmissions are reasonably preventable. In this article, we examine strengths and limitations of the CMS readmission metric, explore how preventable readmissions have been defined and measured, and discuss implications for readmission reduction efforts. Drawing on our clinical, research and operational experiences, we offer suggestions to address the key challenges in moving forward to measure and reduce preventable readmissions. Journal of Hospital Medicine 2014;9:598–603. © 2014 Society of Hospital Medicine