Carey Kathleen, Lin Meng-Yun
Kathleen Carey (
Meng-Yun Lin is a research data analyst in the Section of General Internal Medicine at Boston Medical Center, in Massachusetts.
Health Aff (Millwood). 2016 Oct 1;35(10):1918-1923. doi: 10.1377/hlthaff.2016.0537.
Many observers are calling for modification of Medicare's Hospital Readmissions Reduction Program (HRRP) to relieve an unfair burden on safety-net hospitals, which serve low-income populations and consequently have relatively high readmission rates. To broaden the perspective on this issue, we addressed the fundamental question of whether the HRRP has been an effective tool for reducing thirty-day readmissions in safety-net hospitals. In the first three years of the program, these hospitals reduced readmissions for heart attack by 2.86 percentage points, heart failure by 2.78 percentage points, and pneumonia by 1.77 percentage points, and they also reduced the disparity between their readmission rates and those of other hospitals. While the fairness issue remains unresolved, it appears that safety-net hospitals have been able to respond to HRRP incentives.
许多观察人士呼吁修改医疗保险的医院再入院率降低计划（HRRP），以减轻安全网医院所承受的不公平负担，这些医院为低收入人群服务，因此再入院率相对较高。为了拓宽对这一问题的看法，我们探讨了一个基本问题，即HRRP是否一直是降低安全网医院30天再入院率的有效工具。在该计划实施的头三年，这些医院将心脏病发作的再入院率降低了2.86个百分点，心力衰竭的再入院率降低了2.78个百分点，肺炎的再入院率降低了1.77个百分点，并且它们还缩小了自身再入院率与其他医院再入院率之间的差距。虽然公平问题仍未得到解决，但安全网医院似乎已经能够对HRRP的激励措施做出回应。
