Upadhyay Soumya, Stephenson Amber L, Smith Dean G
1 University of Nevada, Las Vegas, USA.
2 Clarkson University, Schenectady, NY, USA.
Inquiry. 2019 Jan-Dec;56:46958019860386. doi: 10.1177/0046958019860386.
This longitudinal study examines whether readmission rates, made transparent through Hospital Compare, affect hospital financial performance by examining 98 hospitals in the State of Washington from 2012 to 2014. Readmission rates for acute myocardial infarction (AMI), pneumonia (PN), and heart failure (HF) were examined against operating revenues per patient, operating expenses per patient, and operating margin. Using hospital-level fixed effects regression on 276 hospital year observations, the analysis indicated that a reduction in AMI readmission rates is related with increased operating revenues as expenses associated with costly treatments related with unnecessary readmissions are avoided. Additionally, reducing readmission rates is related with an increase in operating expenses. As a net effect, increased PN readmission rates may show marginal increase in operating margin because of the higher operating revenues due to readmissions. However, as readmissions continue to happen, a gradual increase in expenses due to greater use of resources may lead to decreased profitability.
这项纵向研究通过考察2012年至2014年华盛顿州的98家医院，探讨通过“医院对比”公开的再入院率是否会影响医院的财务绩效。研究针对急性心肌梗死（AMI）、肺炎（PN）和心力衰竭（HF）的再入院率，与每位患者的营业收入、每位患者的运营费用以及营业利润率进行了对比分析。通过对276个医院年度观测数据进行医院层面的固定效应回归分析，结果表明，急性心肌梗死再入院率的降低与营业收入的增加相关，这是因为避免了与不必要再入院相关的昂贵治疗费用。此外，降低再入院率与运营费用的增加有关。作为净效应，肺炎再入院率的增加可能会使营业利润率略有提高，因为再入院带来了更高的营业收入。然而，随着再入院情况持续发生，由于资源使用增加导致的费用逐渐上升可能会导致盈利能力下降。
