Department of MMIS, University of Tennessee at Martin, Martin, Tennessee, USA.
Baptist Memorial Hospital Union City, Union City, Tennessee, USA.
Int J Health Care Qual Assur. 2020 Jul 9;ahead-of-print(ahead-of-print). doi: 10.1108/IJHCQA-03-2019-0066.
The purpose of this paper is to examine whether patient readmission rates are associated with patient satisfaction and Medicare reimbursement rates in the US hospitals.
DESIGN/METHODOLOGY/APPROACH: The Hospital Compare database was obtained from the Centers for Medicare and Medicaid Services (CMS) in the US. A total of 2,711 acute care hospitals were analyzed for this present study. The data included patient satisfaction surveys, hospital 30-days readmission ratios for heart failure and pneumonia patients and related payments. Exploratory factor analysis was applied in the first stage to operationalize constructs for scale development. Partial least squares (PLS) modeling analysis via Smart-PLS was utilized for testing the hypotheses.
Results indicated that data provided from the Hospital Compare database for the acute care hospitals accurately reflect quality outcomes. Nevertheless, the Medicare Hospital Readmissions Reduction Program (HRRP) did not penalize the hospitals when patients reported lower satisfaction via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.
ORIGINALITY/VALUE: The findings suggest that a high-readmission rate is not associated with lower payment. Such results appear to conflict with the goals of value-based purchasing programs, which seek to penalize hospitals financially for higher readmission rates.
本文旨在研究美国医院的患者再入院率是否与患者满意度和医疗保险报销率有关。
设计/方法/途径：本研究分析了来自美国医疗保险和医疗补助服务中心（CMS）的医院比较数据库中的 2711 家急症护理医院。该数据包括患者满意度调查、心力衰竭和肺炎患者的医院 30 天再入院率以及相关支付情况。在第一阶段应用探索性因子分析对量表开发的结构进行了操作化。通过 Smart-PLS 进行偏最小二乘法（PLS）建模分析以检验假设。
结果表明，医院比较数据库为急症护理医院提供的数据准确反映了质量结果。然而，当患者通过医院消费者评估医疗保健提供者和系统（HCAHPS）评分报告满意度较低时，医疗保险医院再入院率降低计划（HRRP）并没有对医院进行处罚。
原创性/价值：研究结果表明，高再入院率与低支付并不相关。这些结果似乎与基于价值的购买计划的目标相冲突，这些计划旨在通过提高再入院率对医院进行经济处罚。
