Healthcare News & Insights

Good news: When readmissions decrease, fewer people die

Because of the growing focus on readmissions, many healthcare experts were worried that other areas could be negatively affected by the push to keep people out of the hospital – specifically, mortality rates. However, new research offers good news on this front. 

A recent study published in the Journal of the American Medical Association (JAMA) examined the relationship between readmission rates and deaths. Researchers wanted to determine if lower readmission rates were associated with elevated mortality rates, per an NPR article about the study.

Positive outcomes

Ever since the Centers for Medicare & Medicaid Services (CMS) started penalizing hospitals with high readmissions for patients with several different conditions, readmission rates have been declining.

In fact, 30-day readmission rates for those conditions (heart attack, heart failure and pneumonia) have declined by 20% since the Medicare Hospital Readmission Reduction Program began in 2012.

Although CMS wants this trend to continue, it’s important to make sure the decrease isn’t coming at the expense of patient outcomes. To discover if there was a negative relationship between the two, researchers looked at over 6 million hospital stays for patients at more than 5,000 hospitals from 2008 to 2014.

Result: There is a relationship, but it’s a positive one.

Researchers actually discovered small decreases in mortality rates when looking at readmissions. Hospitals with the biggest declines in readmission rates were more likely to have lower morality rates – even when looking at heart failure, which had rising death rates overall.

What worked for hospitals

When examining the most successful hospitals that reduced readmissions without raising death rates, the biggest factor in improving outcomes was adopting a philosophy for patient-centered care.

Providers at the best performing facilities were encouraged to engage patients and their families, making them more active participants in the recovery process. Clinicians have made more of an effort to use clear language when answering questions or relaying discharge instructions, and they’re making sure everyone understands what must be done after the hospital stay ends.

Better coordination of care has also played a role, according to an editorial in JAMA that accompanies the study.

Due to the shift toward value-based reimbursement, bundled payments and other federal initiatives designed to boost quality, more hospitals are working closely with primary care providers and outside specialists to make sure patients schedule follow-up appointments upon discharge. That way, patients can be monitored more closely, which can help them keep their conditions under control.

Some facilities have taken it a step further, going out of their way to coordinate certain aspects of patients’ care themselves, such as arranging follow-up phone calls to see if patients are taking their medications as prescribed – and even scheduling house calls for patients after they’ve received major surgery.

Bottom line

It’s clear that when hospitals use proactive strategies focused on empowering patients and boosting coordination across the continuum of care (combined with general best practices for treatment), outcomes improve across the board.

Facilities must continue this progress, drawing inspiration from successful hospitals to continue working toward improvement. At this stage in the game, both patients’ lives and hospitals’ reimbursement are on the line.

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