Hospital readmissions first appeared in the medical literature in 1953 in work by Moya Woodside examining outcomes in psychiatric patients in London.
Over time, hospital readmission rates have become a common outcome in health services research, with a large body of literature describing them, including their frequency, their causes, which patients and which hospitals are more likely to have high rates of readmissions, and various methods to prevent them.
In 2009, CMS began publicly reporting readmission rates for myocardial infarction, heart failure, and pneumonia for all non-federal acute care hospitals.
In an effort to use readmission as a measure of hospital quality, CMS contracted with the Yale-New Haven Services Corporation/Center for Outcomes Research and Evaluation (CORE) to develop a hospital-wide readmission (HWR) measure, which it began publicly reporting on Hospital Compare in 2013.
Readmissions occurring at a later time may not be related to care provided during the index admission, and might be more related to the outpatient care the person receives, their individual health choices and behaviors, and larger community-level factors beyond the control of the hospital.
Hospital readmission rates are risk adjusted for a number of variables to allow more accurate comparisons across health systems.
[1] This was partly a result of the 2007 "Promoting Greater Efficiency in Medicare" report which recognized the prevalence and cost of readmissions nationwide.
CMS plans to add coronary artery bypass graft (CABG) surgery to the list in 2017.
To reach these calculations, up to three previous years of a hospital's data and a minimum of 25 cases for each applicable condition are used.
Congress agreed to fund $500 million to this 5-year pilot program, in hopes to aid the Community Based Organizations (CBO) in better quality care.
[13] CBO's are required to provide continuing care after the patients are discharged in one of five different ways.
The CBO's provide education and medication administration to discharged patients in a way that fits their cultural and linguistic needs.
[13] By having key communication between both the sending and receiving healthcare teams, CBO's aid in reduced readmissions.
[13] Section 3024 of the Affordable Care Act created The Independence at Home Demonstration Program (IAH) that was announced in 2010 and later started in 2012.
[15][16] By using mobile teams with electronic information technology, the IAH can improve coordinated healthcare and allow for chronically ill patients to be seen as often as needed.
[20] One of the advantages of the bundled payment program is that it incentivizes hospitals not to discharge patients too early, as the post-acute care facility will just have to deal with the implications that come with that.