Background

Readmissions are an area of quality improvement receiving considerable attention due to the cost and the impact on quality of care. The Medicare Payment Advisory Committee (MedPAC) estimates that 13% of hospital readmissions for Medicare patients could have been prevented, saving Medicare $12 billion (in 2005). Medicare has also started looking at readmissions, proposing several different approaches in the proposed IPPS rule, including reducing payment for a subsequent readmission, providing a higher payment for those with low readmission rates and public reporting of readmission rates. A recent study from the National Center for Health Statistics estimates that 2.3 million ED visits were made by persons who had been hospitalized within the last seven days, and uninsured persons were nearly three times more likely to make an ED visit following a hospital discharge.

Florida is the first state in the country to publish readmission rates on a consumer Web site. Beginning in June, consumers can compare readmission rates for 54 common conditions and procedures on the Agency for Health Care Administration's (AHCA) consumer Web site, www.floridahealthfinder.gov. Using a methodology developed by 3M Health Information Systems which focuses on "potentially preventable" readmissions, consumers can view and compare by the percentage of patients returning to the hospital within 15 days. The AHCA data found:

  • 105,000 or 7.3% of patients had potentially preventable readmissions
  • 83% of these readmissions came back to the emergency department before being readmitted
  • Readmitted patients had an average cost of $31,643 for the readmission and the average length of stay was 6.1 days
  • 26% of the patients were readmitted to a different hospital
  • Medicaid patients had the highest readmission rate, with 10% being readmitted within 15 days; five percent of the uninsured patients were readmitted within 15 days
  • 48% of the readmissions were for cardiology related conditions and procedures
 
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