Hospital readmissions not linked to mortality

How well hospitals keep patients alive isn't associated with how well they do at keeping patients from bouncing back to their facilities, concludes a study in yesterday's Journal of the American Medical Association.

Researchers looked at Medicare patients who had heart attacks or pneumonia between 2005 and 2008 and found no link between hospital readmission rates and mortality rates.

Moreover, hospital factors, such as ownership structure and teaching status, had little to no effect on the relationship between readmissions and deaths, MedPage Today reported.

The study also indicted hospitals should be tracking both measures of readmissions and mortality to gauge quality.

"I feel we've dispelled the notion that your performance in mortality will dictate your performance in readmission," lead study author Harlan Krumholz of Yale University School of Medicine told Kaiser Health News. "This result says they appear to be measuring different things, they're not strongly related to each other, and you can clearly do well on both."

Such findings are important given the Centers for Medicare & Medicaid Services uses both readmission and mortality rates to determine Medicare reimbursements.

But for some healthcare leaders, the study reinforced doubts about using readmissions and mortality rates as CMS quality indicators at all.

"It may be a good way to promote greater accountability for what happens to patients after they leave. But, as a measure of hospital quality, not as much," Ashish Jha, a professor at the Harvard School of Public Health, told KHN.

Skeptics point to supporting research, including recent studies from the University of Rochester Medical Center, the University of California, San Francisco Medical Center and the Yale School of Medicine, that suggest mortality and readmission rates are not the best assessment of hospital care quality.

For more:
- check out the JAMA study
- read the KHN article
- here's the MedPage Today article