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Background  Thirty‐day readmission after percutaneous coronary intervention ( PCI ) is common, costly, and linked to poor patient outcomes. Accordingly, facility‐level 30‐day readmission rates have been considered as a potential quality measure. However, it is unknown whether facility‐level 30‐day readmission rates are associated with facility‐level mortality. We sought to determine the effect of 30‐day readmissions after  PCI  on mortality at both the patient and facility level in the Veterans Administration hospital system.    Methods and Results  We included all patients who underwent  PCI  in the Veterans Administration hospital system nationally from October 2007 through August 2012, comparing all‐cause mortality rates between patients with and without 30‐day readmissions following  PCI . Patients were then aggregated at the hospital level to evaluate the correlation between hospital‐level readmission rates with hospital‐level 1‐year mortality rates. Among 41 069 patients undergoing  PCI  at 62 sites, 12.2% were readmitted within 30 days of discharge. Patients with 30‐day readmission had higher risk‐adjusted mortality (hazard ratio 1.53, 95%  CI  1.44–1.63,  P <0.0001). Facilities varied widely in 30‐day readmission rates (systemwide range of 6.6–19.4%, median 11.8%, interquartile range 10.0–13.2%); however, adjusted facility‐level readmission rates were not correlated with adjusted 1‐year mortality rates.    Conclusions  Thirty‐day readmissions after  PCI  are common and are a significant risk factor for mortality for individual patients even after robust statistical adjustment for clinical confounding. However, lack of correlation between readmission and mortality at the facility level suggests that quality improvement based on facility‐level readmission rates will not modify mortality in this high‐risk group.

journal of the american heart association

Facility‐Level Percutaneous Coronary Intervention Readmission Rates Are Not Associated With Facility‐Level Mortality: Insights From the  VA  Clinical Assessment, Reporting, and Tracking ( CART ) Program