Ayabakan Sezgin, Bardhan Indranil, Zheng Zhiqiang Eric
Management Information Systems Department, Fox School of Business, Temple University, Philadelphia, PA, USA.
Information Risk and Operations Management Department, McCombs School of Business, The University of Texas at Austin, Austin, TX, USA.
Health Serv Res Manag Epidemiol. 2021 Feb 17;8:2333392821993704. doi: 10.1177/2333392821993704. eCollection 2021 Jan-Dec.
Despite substantial attention on hospital readmission rates, the impact of the Hospital Readmission Reduction Program (HRRP) on a comprehensive set of Triple Aim goals has not been studied: improve hospital quality, reduce cost, and improve patient experience.
We analyze inpatient claims data from 2006 to 2015 from the Dallas Fort Worth Hospital Council Foundation with a panel of 27,397 patients with chronic obstructive pulmonary disease and congestive heart failure. We deploy a quasi-natural experiment using a difference-in-difference specification to estimate the effect of HRRP effect on readmission rates, length of stay (LOS), and hospital satisfaction.
We find that the likelihood of 30-day readmissions declined by 2.6%, average LOS decreased by 7.9%, and overall hospital rating increased by 2.1% among hospitals that fell under the scope of the HRRP, compared to non-HRRP hospitals. Our results provide evidence of a spillover effect of the HRRP in terms of its impact not only on Medicare patients, but across all insurance types, and other performance measures such as cost and patient experience.
Our findings indicate that HRRP hospitals do not trade-off reductions in readmission rates with lower quality across other patient health outcomes. Rather, we find evidence that the HRRP has affected all 3 dimensions of the Triple Aim with respect to patient and hospital outcomes.
尽管医院再入院率受到了广泛关注，但医院再入院率降低计划（HRRP）对一系列综合的三重目标的影响尚未得到研究，这些目标包括提高医院质量、降低成本和改善患者体验。
我们分析了达拉斯沃思堡医院委员会基金会2006年至2015年的住院患者索赔数据，涉及一组27397名慢性阻塞性肺疾病和充血性心力衰竭患者。我们采用双重差分法进行准自然实验，以估计HRRP对再入院率、住院时间（LOS）和医院满意度的影响。
我们发现，与非HRRP医院相比，处于HRRP范围内的医院30天再入院的可能性下降了2.6%，平均住院时间减少了7.9%，总体医院评级提高了2.1%。我们的结果提供了证据，证明HRRP不仅对医疗保险患者有影响，而且对所有保险类型以及成本和患者体验等其他绩效指标都有溢出效应。
我们的研究结果表明，HRRP医院在降低再入院率的同时，并没有在其他患者健康结果方面以降低质量为代价。相反，我们发现有证据表明，HRRP在患者和医院结果方面影响了三重目标的所有三个维度。
