Objectives To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions.
Conclusions High performing hospitals have proportionately fewer 30 day readmissions without differences in readmission diagnoses and timing, suggesting the possible benefit of strategies that lower risk of readmission globally rather than for specific diagnoses or time periods after hospital stay.
Our national study examined readmission diagnoses and timing patterns across hospitals with different performance profiles.
4 5 Little is known about the relation between hospital rates of readmission and the diagnoses and timing of readmissions.
We found that in contemporary practice, readmission diagnoses and timing after admission for heart failure, acute myocardial infarction, or pneumonia do not differ by hospital 30 day risk standardized readmission rates.
The findings extend previous work on the predictors of hospital performance 17 18 19 by showing that high performing hospitals with low 30 day risk standardized readmission rates maintain a similar pattern of readmission diagnoses and timing as lower performing institutions.
In contemporary practice, hospitals with different 30 day readmission rates after index admissions for heart failure, acute myocardial infarction, or pneumonia have a similar distribution of readmissions with regard to their diagnoses and timing.
10 11 12 To compare readmission diagnoses and timing across hospitals of different performance levels, we used the bootstrap algorithm to construct a 95% interval estimate for each 30 day risk standardized readmission rate and divided hospitals into high, average, and low performers for each index condition.
The main variables collected for the purposes of this study were the daily numbers of patients attending the ED, and the individual SATS scores (colours); surveillance diagnoses; the timings of arrival/triage, clinical consultation and discharge; and the patient ED outcomes.
Supplementary Figure S3 suggests that the uplift in diagnoses surrounding the timing of the campaign began to return to pre-campaign levels from around August.
