Has the Hospital Readmissions Reduction Program Affected Heart Failure Outcomes?
HealthDay News — Implementation of the Hospital Readmissions Reduction Program (HRRP) is associated with a reduction in readmissions for patients with heart failure but also with an increase in mortality, according to a study published online November 12 in JAMA Cardiology to coincide with the American Heart Association's Scientific Sessions, being held November 11 to 15 in Anaheim, California.
Ankur Gupta, MD, PhD, from Harvard Medical School in Boston, and colleagues examined the correlation of the HRRP with readmission and mortality outcomes in patients hospitalized for heart failure. Data were included for 115,245 Medicare beneficiaries across 416 U.S. hospital sites participating in the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) registry.
The researchers found that there was a decrease in the 30-day risk-adjusted readmission rate, from 20% before HRRP implementation to 18.4% in the HRRP penalties phase (hazard ratio, 0.91). In contrast, an increase was seen in the 30-day risk-adjusted mortality rate, from 7.2% before HRRP implementation to 8.6% in the HRRP penalties phase (hazard ratio, 1.18). A similar pattern was seen for the 1-year risk-adjusted readmission and mortality rates, with a decline in the readmission rate from 57.2 to 56.3% (hazard ratio, 0.92) and an increase in the mortality rate from 31.3 to 36.3% (hazard ratio, 1.1).
"If confirmed, this finding may require reconsideration of the HRRP in heart failure," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry, and the study was partially funded by the GWTG-HF program, which received funding from pharmaceutical and medical device companies.