No Link Between Mortality, Readmission Quality Measures
(HealthDay News) – As measures of hospital quality, there is no association between risk-standardized mortality rates and readmission rates for elderly individuals hospitalized for acute myocardial infarction or pneumonia and a weak association for patients with heart failure, according to a study published in the Feb. 13 issue of the Journal of the American Medical Association.
Harlan M. Krumholz, MD, from Yale University in New Haven, CT, and colleagues examined the correlation between hospital 30-day, all-cause, risk-standardized mortality rates (RSMRs) and 30-day, all-cause, risk-standardized readmission rates (RSRRs) for Medicare fee-for-service beneficiaries hospitalized for acute myocardial infarction, heart failure, or pneumonia between 2005 and 2008.
The researchers found that mean RSMR, mean RSRR, and correlation between the two, was 16.6%, 19.94%, and 0.03 for acute myocardial infarction; 11.17%, 24.56%, and −0.17 for heart failure; and 11.64%, 18.22%, and 0.002 for pneumonia. Subgroup analysis showed that hospital characteristics such as hospital type or region, safety net status, and urban/rural status did not affect the correlations. Although there was a significant negative relationship between RSMR and RSRR for heart failure, the shared variance was 2.9% and the correlation was strongest for hospitals with RSMR of <11%.
"From a policy perspective, the independence of the measures is important," Krumholz and colleagues conclude. "Our findings indicate that many institutions do well on mortality and readmission and that performance on one does not dictate performance on the other."
Two authors disclosed receiving research grants from Medtronic and serving as scientific advisors for UnitedHealth and FAIR Health.