Hospitals

Does reducing readmission rates mean increased mortality?

A new JAMA study took a deeper dive into whether reductions in hospital readmissions increased patient mortality rates after hospitalization. The results are good news for fans of value-based care.

The benefits of value-based care are becoming more and more clear, as underscored by the latest JAMA study.

Researchers set out to find whether Affordable Care Act-related reductions in hospital readmissions happened to increase patient mortality rates post-discharge.

Thus, they studied more than 5 million Medicare fee-for-service hospitalizations between January 1, 2008, and December 31, 2014. All patients were 65 or older and hospitalized for either heart failure, acute myocardial infarction or pneumonia.

In sum, the researchers analyzed 2,962,554 heart failure hospitalizations at 5,016 hospitals; 1,229,939 hospitalizations for acute myocardial infarction at 4,772 hospitals; and 2,554,530 hospitalizations for pneumonia at 5,057 hospitals.

The results?

Lowering readmission rates did not appear to have any adverse effects on patient mortality.

“Among Medicare fee-for-service beneficiaries hospitalized for heart failure, acute myocardial infarction or pneumonia, reductions in hospital 30-day readmission rates were weakly but significantly correlated with reductions in hospital 30-day mortality rates after discharge,” the researchers concluded.

They added that the “findings do not support increasing post-discharge mortality related to reducing hospital readmissions.”

In a recent phone interview, Cheri Bankston, director of clinical advisory services for Brentwood, Tennessee-based naviHealth, said she wasn’t surprised by the results of the JAMA study.

“I didn’t expect it to impact the mortality rate,” she said. Though Bankston did point out the fact that the patient population included in the study is important to consider. Extraneous elements such as the patient’s support system, community resources and socioeconomic factors should also be taken into consideration.

But overall, the study shows that seeking the best outcomes for patients results in reduced readmission rates and better quality of care.

“It’s no longer just making sure the patient is stable and ready to be discharged,” Bankston said. “Now we’re looking beyond the four walls of the hospital.”

The study’s results are good news for the future of value-based care.

“I think of this as a resounding A-plus that we’re on the right track and we need to continue,” Bankston said. “This study is one way to put numbers behind it that yes, this does make a difference.”

She stressed the continued need to spread the news of the study, especially to those resistant to value-based initiatives. “It’s kind of a good message to take forward and encourage others to get on board with these partnerships,” she added.

And this new research isn’t the only analysis proving the benefits of value-based care. A previously published JAMA Internal Medicine study found hospitals participating in one or more value-based programs have lower readmission rates.

Photo: Bill Oxford, Getty Images

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