Study sees little connection between mortality and hospital readmissions

Yale School of Medicine researchers have found that there isn’t a strong link between mortality and hospital readmissions. In the report, published in the Feb. 13 issue of the Journal of the American Medical Association (JAMA).

“Our findings show that many institutions do well on mortality and readmission and that performance on one does not dictate performance on the other,” said the study’s lead author, Harlan M. Krumholz, M.D., the Harold H. Hines, Jr. Professor of Medicine (cardiology) and professor of investigative medicine and of public health (health policy) in a press release.

“We found that hospitals can excel in both areas, dispelling prevalent concerns that hospitals that do well on mortality will necessarily do worse on readmission,” he added.

According to a press release put out by the university, the Yale study included data on nearly 3 million hospital admissions for Medicare fee-for–service beneficiaries with heart attack, pneumonia or heart failure. The researchers measured a hospital’s performance on 30-day readmission rates, and investigated the relationship between hospital risk-standardized mortality rates and risk-standardized readmission rates overall and within subgroups defined by hospital characteristics. Krumholz and co-authors found that the average mortality rate was 11 percent for heart failure, close to 17 percent for heart attack, and 11.5 percent for pneumonia patients.

“This study is important because it reveals that there is no relationship between these measures and suggests that what it may require to excel in one measure may not translate into good performance on the other,” said Krumholz in the release. “The measures are leading hospitals to invest in quality — and this study shows ideally they will be able to find ways to help people survive in the hospital and have a successful recovery — but that each area may require efforts that are specific to it.”

Other authors on the study include Zhenqiu Lin, Patricia Keenan, Jersey Chen, M.D., Joseph Ross, M.D., Elizabeth Drye, M.D., Susannah Bernheim, M.D., Yun Wang, Elizabeth Bradley, Lein Han, and Sharon-Lise Normand.

The study was supported by the Center for Cardiovascular Outcomes Research at Yale with funding from the National Heart, Lung, and Blood Institute (U01 HL105270-03); Career Development Award from the Agency for Healthcare Research and Quality; National Institute on Aging and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program (K08AG032886-05); CMS, an agency of the U.S. Department of Health and Human Services.

Amanda Cuda