We’ve written before about the issue of hospital readmissions, but we just wanted to point to an excellent post this week by Anne-Marie J. Audet, M.D., MSc., the VP of Health System Quality and Efficiency at over at the Commonwealth Fund. Audet points out the deficiencies surrounding rehospitalization rate reporting -- though we have solid rehospitalization studies looking at Medicare patients only, these studies are limited in scope and cannot give us an accurate picture of the health system as a whole. She calls for a standardized national measure for reporting rehospitalizations and improved data systems to make sure reporting is timely. Audet writes:
Several national reports published…feature rehospitalization rates, and some have tracked rates over time. Yet, two problems persist: each group has adopted a different definition of rehospitalization, which makes comparisons and benchmarking across states, regions, and hospitals impossible, and most reports are based on data that are more than two years old.
One reason for the measurement conundrum we face today is that basic data are difficult to obtain. For instance, in many states only Medicare data are available and using those databases require special analytic expertise. Many states face significant challenges in getting data to track rehospitalizations for the under-65 population. And for smaller hospitals, where rehospitalizations are not that frequent, the need to collect data over a longer time period to ensure stability in the calculated rates leads to results that are not really actionable when it comes to improving performance.
In light of the scope of this national problem, the lack of timely information on all patients and a standard way to measure rehospitalizations is no longer tenable. Rehospitalizations are prevalent, harmful to patients, and costly. More important, they are a symptom of our fragmented health care system, which is still working within silos. To move toward greater levels of care coordination, integration, and accountability, we must have standard measures to track progress. After all, what gets measured gets done.
The new measures should apply to all patients, regardless of who insures them and where they receive their care. And the country must invest in information systems that can provide the timely data—not five-year-old or even six-month-old data—that are necessary to monitor and take appropriate steps when problems are identified.
… National standards for rehospitalizations will enable patients to engage in their care; providers to monitor what works and where they may need to intervene once a problem is identified; regulators to develop effective regulations; and payers to develop appropriate payment incentives to foster high levels of performance. It is imperative that we seize the chance to implement standards now.
Read the entire post here. And check out our colleague Joanne Kenen’s Washington Post piece about rehospitalizations here.