1 Senscio Systems, Inc., Boxborough, Massachusetts.
2 RAND Health, RAND Corporation, Santa Monica, California.
Popul Health Manag. 2019 Jun;22(3):243-247. doi: 10.1089/pop.2018.0103. Epub 2018 Nov 7.
The Medicare Readmissions Reduction Program penalizes hospitals with higher than expected readmission rates after discharge for congestive heart failure (CHF). This exploratory study analyzed whether categorizing readmissions by event severity might have implications for the program. The authors used the 5% MedPAR (Medicare Provider and Analysis Review) data for 2008 to 2014 and ranked 1820 hospitals based on all readmissions, readmissions for CHF, short-stay CHF readmissions, and readmissions for severe CHF with evidence of cardiogenic shock. Ranking hospitals based on severe CHF readmissions changes their relative rank order significantly compared to counting all readmissions. If confirmed in the full Medicare data, the finding could inform the design of the Readmission Reduction Program.
医疗保险再入院率降低计划对出院后充血性心力衰竭（CHF）再入院率高于预期的医院进行处罚。本探索性研究分析了按事件严重程度对再入院进行分类是否对该计划有影响。作者使用了 2008 年至 2014 年的 5% MedPAR（医疗保险提供者和分析审查）数据，并根据所有再入院、CHF 再入院、短期 CHF 再入院以及伴有心源性休克证据的严重 CHF 再入院对 1820 家医院进行了排名。根据严重 CHF 再入院对医院进行排名与计算所有再入院相比，会显著改变它们的相对排名顺序。如果在完整的医疗保险数据中得到证实，这一发现可以为再入院率降低计划的设计提供信息。
