Hospital guidelines not linked to readmissions

Procedural guidelines designed to ensure patients get quality care while in the hospital are also thought to reduce the chances a patient will need to be readmitted down the line, but a new study suggests there’s little connection between the two.

“The idea was, increasing the quality of care provided by these hospitals would improve the outcomes,” said the report’s lead author Dr. Michaela S. Stefan, an academic hospitalist at Baystate Medical Center in Springfield, Mass.

In an effort to control costs, both hospitals and the federal government have been trying for some time to lower the number of patients who are readmitted to the hospital within 30 days of being discharged.

Starting in October, a hospital’s readmission rates are one factor the Centers for Medicare and Medicaid Services (CMS) take into account when deciding what to pay for patient treatment.

Right now, about one in four patients will be readmitted to the hospital within 30 days, according to Stefan and her colleagues. And it’s estimated that those unplanned rehospitalizations cost Medicare $17.6 billion in 2004.

One approach to lowering readmissions has been the creation of quality care guidelines for specific conditions, such as heart attack or pneumonia.

CMS also reports readmission numbers for hospitals on the website Hospital Compare: 1.usa.gov/Z7TeXy.

Still, researchers have been asking whether these approaches make a difference in readmission rates.

Another recent study suggested that many factors outside a hospital’s control can cause a patient to need rehospitalization. For example, the person’s ability to keep up with their medications at home, or to make follow-up visits to a personal physician (see Reuters Health article of October 19, 2012, here: reut.rs/Z7uCy9).

For the new study, Stefan and her colleagues looked at whether the degree to which a hospital followed guidelines to the letter predicted how many Medicare patients came back within 30 days of their first discharge.

Using a 2007 database of patients on the government insurance program for seniors, the researchers analyzed patient outcomes for a number of ailments and surgical procedures, including heart attacks, heart failure, pneumonia and stomach, heart and orthopedic surgeries.

Overall, the study included information on patients from thousands of hospitals across the U.S.

For instance, 2,773 hospitals treated 322,668 people for heart failure during the study period while 2,940 hospitals treated 328,830 people with pneumonia.

The researchers gave each hospital a score between zero and 100 percent, based on the percentage of patients who received all the recommended treatments for their condition.

For heart attack patients, these could include receiving an aspirin when they arrived at the hospital or, if appropriate, smoking cessation counseling before discharge. For pneumonia patients, prescribing the correct antibiotics and checking on a patient’s flu vaccine status are among procedures on the checklist.

Of the 117,514 heart attack patients, about 96 percent received some of the recommended treatments. However, only about 88 percent got all of them.

And about 80 percent of stomach surgery patients got some of the recommended treatments, but only about 46 percent received them all.

The researchers then looked at how many of those patients returned to the hospital within 30 days after being discharged.

Overall, they found that hospitals with the best scores for following guidelines did not have “meaningfully” lower readmissions than hospitals with the worst scores.

“Even when the associations were statistically significant, the differences in the readmission rates of high and low-performing hospitals were small,” the team writes in the Journal of General Internal Medicine.

The researchers add that some possible reasons for the lack of association between the two measures could be that these guidelines have “little impact on the risk of readmission” or that the guidelines are too broadly defined.

The study itself did have limitations too, they acknowledge.

For example, it only looked at Medicare patients over 66 years old, so the findings may not apply to younger people. Also, the data are only from a single year and were based on what was reported to Medicare from the hospital records, so the information may not be complete.

Nevertheless, the researchers conclude that encouraging hospitals to report these guideline data to the public, such as on Hospital Compare, will do little to lower readmission rates.

Still, it’s good information to provide to patients, Stefan said.

“It’s important to know that the Hospital Compare site exists. Unfortunately, the public accesses Hospital Compare very little,” she added.

Leave a Reply

Your email address will not be published. Required fields are marked *

universo-virtual.com

buytrendz.net

thisforall.net

benchpressgains.com

qthzb.com

mindhunter9.com

dwjqp1.com

secure-signup.net

ahaayy.com

soxtry.com

tressesindia.com

puresybian.com

krpano-chs.com

cre8workshop.com

hdkino.org

peixun021.com

qz786.com

utahperformingartscenter.org

maw-pr.com

zaaksen.com

ypxsptbfd7.com

worldqrmconference.com

shangyuwh.com

eejssdfsdfdfjsd.com

playminecraftfreeonline.com

trekvietnamtour.com

your-business-articles.com

essaywritingservice10.com

hindusamaaj.com

joggingvideo.com

wandercoups.com

onlinenewsofindia.com

worldgraphic-team.com

bnsrz.com

wormblaster.net

tongchengchuyange0004.com

internetknowing.com

breachurch.com

peachesnginburlesque.com

dataarchitectoo.com

clientfunnelformula.com

30pps.com

cherylroll.com

ks2252.com

webmanicura.com

osostore.com

softsmob.com

sofietsshotel.com

facetorch.com

nylawyerreview.com

apapromotions.com

shareparelli.com

goeaglepointe.com

thegreenmanpubphuket.com

karotorossian.com

publicsensor.com

taiwandefence.com

epcsur.com

odskc.com

inzziln.info

leaiiln.info

cq-oa.com

dqtianshun.com

southstills.com

tvtv98.com

thewellington-hotel.com

bccaipiao.com

colectoresindustrialesgs.com

shenanddcg.com

capriartfilmfestival.com

replicabreitlingsale.com

thaiamarinnewtoncorner.com

gkmcww.com

mbnkbj.com

andrewbrennandesign.com

cod54.com

luobinzhang.com

bartoysdirect.com

taquerialoscompadresdc.com

aaoodln.info

amcckln.info

drvrnln.info

dwabmln.info

fcsjoln.info

hlonxln.info

kcmeiln.info

kplrrln.info

fatcatoons.com

91guoys.com

signupforfreehosting.com

faithfirst.net

zjyc28.com

tongchengjinyeyouyue0004.com

nhuan6.com

oldgardensflowers.com

lightupthefloor.com

bahamamamas-stjohns.com

ly2818.com

905onthebay.com

fonemenu.com

notanothermovie.com

ukrainehighclassescort.com

meincmagazine.com

av-5858.com

yallerdawg.com

donkeythemovie.com

corporatehospitalitygroup.com

boboyy88.com

miteinander-lernen.com

dannayconsulting.com

officialtomsshoesoutletstore.com

forsale-amoxil-amoxicillin.net

generictadalafil-canada.net

guitarlessonseastlondon.com

lesliesrestaurants.com

mattyno9.com

nri-homeloans.com

rtgvisas-qatar.com

salbutamolventolinonline.net

sportsinjuries.info

topsedu.xyz

xmxm7.com

x332.xyz

sportstrainingblog.com

autopartspares.com

readguy.net

soniasegreto.com

bobbygdavis.com

wedsna.com

rgkntk.com

bkkmarketplace.com

zxqcwx.com

breakupprogram.com

boxcardc.com

unblockyoutubeindonesia.com

fabulousbookmark.com

beat-the.com

guatemala-sailfishing-vacations-charters.com

magie-marketing.com

kingstonliteracy.com

guitaraffinity.com

eurelookinggoodapparel.com

howtolosecheekfat.net

marioncma.org

oliviadavismusic.com

shantelcampbellrealestate.com

shopleborn13.com

topindiafree.com

v-visitors.net

qazwsxedcokmijn.com

parabis.net

terriesandelin.com

luxuryhomme.com

studyexpanse.com

ronoom.com

djjky.com

053hh.com

originbluei.com

baucishotel.com

33kkn.com

intrinsiqresearch.com

mariaescort-kiev.com

mymaguk.com

sponsored4u.com

crimsonclass.com

bataillenavale.com

searchtile.com

ze-stribrnych-struh.com

zenithalhype.com

modalpkv.com

bouisset-lafforgue.com

useupload.com

37r.net

autoankauf-muenster.com

bantinbongda.net

bilgius.com

brabustermagazine.com

indigrow.org

miicrosofts.net

mysmiletravel.com

selinasims.com

spellcubesapp.com

usa-faction.com

snn01.com

hope-kelley.com

bancodeprofissionais.com

zjccp99.com

liturgycreator.com

weedsmj.com

majorelenco.com

colcollect.com

androidnews-jp.com

hypoallergenicdogsnames.com

dailyupdatez.com

foodphotographyreviews.com

cricutcom-setup.com

chprowebdesign.com

katyrealty-kanepa.com

tasramar.com

bilgipinari.org

four-am.com

indiarepublicday.com

inquick-enbooks.com

iracmpi.com

kakaschoenen.com

lsm99flash.com

nana1255.com

ngen-niagara.com

technwzs.com

virtualonlinecasino1345.com

wallpapertop.net

nova-click.com

abeautifulcrazylife.com

diggmobile.com

denochemexicana.com

eventhalfkg.com

medcon-taiwan.com

life-himawari.com

myriamshomes.com

nightmarevue.com

allstarsru.com

bestofthebuckeyestate.com

bestofthefirststate.com

bestwireless7.com

declarationintermittent.com

findhereall.com

jingyou888.com

lsm99deal.com

lsm99galaxy.com

moozatech.com

nuagh.com

patliyo.com

philomenamagikz.net

rckouba.net

saturnunipessoallda.com

tallahasseefrolics.com

thematurehardcore.net

totalenvironment-inthatquietearth.com

velislavakaymakanova.com

vermontenergetic.com

sizam-design.com

kakakpintar.com

begorgeouslady.com

1800birks4u.com

2wheelstogo.com

6strip4you.com

bigdata-world.net

emailandco.net

gacapal.com

jharpost.com

krishnaastro.com

lsm99credit.com

mascalzonicampani.com

sitemapxml.org

thecityslums.net

topagh.com

flairnetwebdesign.com

bangkaeair.com

beneventocoupon.com

noternet.org

oqtive.com

smilebrightrx.com

decollage-etiquette.com

1millionbestdownloads.com

7658.info

bidbass.com

devlopworldtech.com

digitalmarketingrajkot.com

fluginfo.net

naqlafshk.com

passion-decouverte.com

playsirius.com

spacceleratorintl.com

stikyballs.com

top10way.com

yokidsyogurt.com

zszyhl.com

16firthcrescent.com

abogadolaboralistamd.com

apk2wap.com

aromacremeria.com

banparacard.com

bosmanraws.com

businessproviderblog.com

caltonosa.com

calvaryrevivalchurch.org

chastenedsoulwithabrokenheart.com

cheminotsgardcevennes.com

cooksspot.com

cqxzpt.com

deesywig.com

deltacartoonmaps.com

despixelsetdeshommes.com

duocoracaobrasileiro.com

fareshopbd.com

goodpainspills.com

kobisitecdn.com

makaigoods.com

mgs1454.com

piccadillyresidences.com

radiolaondafresca.com

rubendorf.com

searchengineimprov.com

sellmyhrvahome.com

shugahouseessentials.com

sonihullquad.com

subtractkilos.com

valeriekelmansky.com

vipasdigitalmarketing.com

voolivrerj.com

zeelonggroup.com

1015southrockhill.com

10x10b.com

111-online-casinos.com

191cb.com

3665arpentunitd.com

aitesonics.com

bag-shokunin.com

brightotech.com

communication-digitale-services.com

covoakland.org

dariaprimapack.com

freefortniteaccountss.com

gatebizglobal.com

global1entertainmentnews.com

greatytene.com

hiroshiwakita.com

iktodaypk.com

jahatsakong.com

meadowbrookgolfgroup.com

newsbharati.net

platinumstudiosdesign.com

slotxogamesplay.com

strikestaruk.com

trucosdefortnite.com

ufabetrune.com

weddedtowhitmore.com

12940brycecanyonunitb.com

1311dietrichoaks.com

2monarchtraceunit303.com

601legendhill.com

850elaine.com

adieusolasomade.com

andora-ke.com

bestslotxogames.com

cannagomcallen.com

endlesslyhot.com

iestpjva.com

ouqprint.com

pwmaplefest.com

qtylmr.com

rb88betting.com

buscadogues.com

1007macfm.com

born-wild.com

growthinvests.com

promocode-casino.com

proyectogalgoargentina.com

wbthompson-art.com

whitemountainwheels.com

7thavehvl.com

developmethis.com

funkydogbowties.com

travelodgegrandjunction.com

gao-town.com

globalmarketsuite.com

blogshippo.com

hdbka.com

proboards67.com

outletonline-michaelkors.com

kalkis-research.com

thuthuatit.net

buckcash.com

hollistercanada.com

docterror.com

asadart.com

vmayke.org

erwincomputers.com

dirimart.org

okkii.com

loteriasdecehegin.com

mountanalog.com

healingtaobritain.com

ttxmonitor.com

bamthemes.com

nwordpress.com

11bolabonanza.com

avgo.top