What do re-admission rates measure?
June 10, 2013 1 Comment
Austin Frakt has a post on a paper noting that re-admission rates are not strongly correlated with mortality or process measures of quality of care.
At least some hospital re-admissions are related to problems with the long term care system available to patients; this reality should be added to the readmission mix, especially the discussion about what we are measuring, and what might be done about readmissions? Readmissions as imperfect measures of hospital quality became clear to me from the recent experience that my family has had in providing care to my mother-in-law. The short version is that she was admitted to the hospital 3 times in 40 days in late 2012-early 2013, and all of them were directly related to long term care issues, particularly our inability to successfully deal with wandering in a person with escalating dementia, but who retained fairly robust lower-body mobility. The readmissions had little to do with the hospital in question, if anything at all.
One note however. A key 3 minute conversation between my wife, myself and a hospital social worker during the last inpatient stay was very important. After the first two admissions, my wife was asked by soical workers/discharge planner types: “can you safely care for your mother at home?” During the last admission, the social worker said: “it is obvious to me that you can no longer care for your mother safely at home” which in many ways “allowed” my wife to say that we had to seek institutional long term care, which we did. In any event, expansion to include the long term care system should be added to the discussion of readmissions as measures of “hospital quality.”