Readmission rate culprits remain elusive

Hospitals know they have to care about readmissions to improve patient care and protect their wallets, with reimbursements changes tied to performance. But do they know what really causes readmissions and what they can do to avoid them?

Despite ongoing research to keep patients from bouncing back to the hospital, many organizations are still struggling. In fact, even the number one hospital in the country with the lowest readmission rate for congestive heart failure doesn't know exactly how they accomplished it. St. Patrick Hospital in Montana recently learned it earned the highly desirable spot, based on data from the Center for Medicare & Medicaid Services from 2007 to 2010 at more than 4,000 hospitals nationwide, the Missoulian reported. St. Patrick's Hospital's readmission rate is 18.2 percent, compared to the national average of 24.8 percent. Heart failure is the number one reason of readmissions, the article noted.

Dr. Bradley Berry, a congestive heart failure and cardiac imaging specialist at the International Heart Institute at St. Patrick's, attributes the low readmission rate to appropriate care the first time, frequent follow-up appointments and patient education, including discussing lifestyle changes and eating habits.

The hospital has applied a Robert Wood Johnson Foundation grant to find out what they're doing right.

"We really wanted to understand the cost of care for congestive heart failure patients," Chief of Acute Care Services Joyce Dombrowski said. "They cost a lot of dollars if they're [constantly] in and out. The government wants to prevent readmission. We need to know why we are successful and we feel we have a moral obligation to share it [with other hospitals] so patients elsewhere have the same advantages."

Just this week, researchers at Kaiser Health News and the Yale School of Medicine butted heads (or, rather, studies) over whether or not socioeconomic factors contribute to higher readmission rates. 

If researchers and leaders at the top hospitals in the country still haven't solved the readmissions mystery, what chance do other hospitals stand? Still, even if the culprits for readmissions are elusive, it doesn't mean that hospitals will ever stop trying to find them. - Karen (@FierceHealth)