Skip to content Skip to navigation

Report: Readmission Rates are Misleading

April 23, 2012
by Gabriel Perna
| Reprints

A study from doctors in the departments of neurological surgery and orthopedic surgery at the University of California at San Francisco (UCSF) has concluded there may be problems with how readmissions rates are reported. According to the study, comparing publicly available overall readmission rates can lead to misinformation

The researchers looked at spinal encounters from 2007-2011 at UCSF Medical Center collected from a database maintained by an organization named UHCdatabase. The analysis led them to the estimation that all cause readmission rates overestimate unplanned readmissions by up to 25 percent. All cause readmission rates, which is the Centers for Medicare and Medicaid (CMS) reported metric, don’t distinguish between planned, scheduled, staged surgeries and unplanned surgeries for complications, according to the researchers.

With planned rehospitalizations for spinal surgeries at UCSF Medical Center in institutional readmission rates, there is an inappropriateness of readmission rates currently being reported says the researchers. Hundreds of hospitals nationwide whose readmission rates are all tracked with this same algorithm.

“Publicly reported ‘all cause’ readmission rates may not be realistic,” said Praveen Mummaneni, M.D. the senior author of the report, said in a statement. “To be accurate, substantial drill down of readmission rates is needed to find clinically relevant causes.”

Such rates, the authors note, are also publically reportable, and they may influence how consumers perceive the quality of care they will receive at places like the UCSF Medical Center.

Readmission rates, for instance, do not take into account the complexity of correcting problems involving the spine, which often call for two or more staged surgeries spaced out over several weeks, says Mummaneni. Publicly reported readmission rates do not always take into account scheduled follow-up surgeries and unplanned hospital readmissions, causing the calculated rates to be over-estimated. Additionally, he said, this problem may present surgeons with a tough choice between scheduling multiple surgeries, which may be better for the patients, and scheduling single surgeries, which would improve readmission rate calculations.



ONC National Coordinator Gets Live Look at Carequality Data Exchange

Officials from Carequality have stated that there are now more than 150,000 clinicians across 11,000 clinics and 500 hospitals live on its network. These participants are also able to share health data records with one another, regardless of technology vendor.

American Red Cross, Teladoc to Provide Telehealth Services to Disaster Victims

The American Red Cross announced a partnership with Teladoc to deliver remote medical care to communities in the United States that are significantly affected by disasters.

Report: The Business of Cybercrime in Healthcare is Growing

While stolen financial data still has a higher market value than stolen medical records, as financial data can be monetized faster, there are indications that there is ongoing development of a market for stolen medical data, according to an Intel Security McAfee Labs report.

Phishing Attack at Baystate Health Potentially Exposes Data of 13K Patients

A phishing scam at Baystate Health in Springfield, Mass. has potentially exposed the personal data of 13,000 patients, according to a privacy statement from the patient care organization and a report from MassLive.

New Use Cases Driving Growth in Health Data Exchange through Direct

In an update, DirectTrust reported significant growth in Direct exchange of health information and the number of trusted Direct addressed enabled to share personal health information (PHI) in the third quarter of 2016.

Insurers to CBO: Consider Private Insurers’ Data in Evaluations of Telemedicine

Eleven private insurers, including Aetna, Humana and Anthem, are urging the Congressional Budget Office (CBO) to consider the experience of commercial insurers when evaluating the impact of telemedicine coverage in Medicare.