Hospital 30-day readmission rates vary after inpatient rehabilitation

More than one in 10 Medicare patients are readmitted within 30 days after discharge from inpatient rehabilitation facilities (IRFs), according to a new study published in the Journal of the American Medical Association.

The study represents the first such research on reasons for post-rehab readmissions, according to a statement from the University of Texas Medical Branch at Galveston. "Currently, Medicare spends $20 billion each year on readmissions of hospitalized older adults," said lead author Kenneth Ottenbacher. "The data uncovered in this study is crucial in order to effectively develop new health reimbursement systems that bundle acute and post-acute care to improve quality and contain costs."

Ottenbacher and his team evaluated Centers for Medicare & Medicaid Services (CMS) patient data for lower extremity fracture, lower extremity joint replacement, strokes, brain dysfunction, debility and neurological disorders. These categories account for approximately 75 percent of Medicare fee-for-service patients receiving inpatient rehabilitation, according to the statement.

The overall 30-day readmission rate among patients discharged from rehabilitative services was 11.8 percent, according to the study. Of the six categories, debility had the highest readmission rate with 18.8 percent, while lower extremity joint replacement had the lowest, with 5.8 percent.

Readmission rates were similar between rural and urban facilities and between freestanding and hospital-based facilities, and ranged between 9.2 percent and 13.6 percent geographically. Michigan had the highest rates, while Idaho and Washington state had the lowest, according to the statement.

Despite the amount of data, researchers said it was not enough to draw clear conclusions about the relationship between rehab facilities and readmissions. "Further research is needed to understand the causes of readmission," the authors wrote.

Pressure is mounting for IRFs to improve readmission rates. This fiscal year, the CMS will add 30-day readmissions to the national quality indicators for such facilities, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the statement