Standard hospital readmission practices flawed, says new Northwestern research

Daniel Schlessinger, Reporter

A common standard used to measure the quality of hospitalization care may not be effective, according to new research from Northwestern’s Feinberg School of Medicine.

In a January article published in the Journal of the American Medical Association, Feinberg Prof. Mihai Gheorghiade suggested that the use of a 30-day readmission policy, which measures the proportion of patients who have to revisit the hospital within 30 days of their discharge, may compromise effective hospital treatment. The measure is widely used in fields such as oncology and cardiology. If hospitals readmit too many patients within the 30-day window, they are often financially penalized, he said.

For patients with heart failure, the measure may not have any medical basis and perhaps does more harm than good. If a patient needs to be readmitted 29 days after their discharge, financial penalties within the 30-day limit may incentivize hospitals to wait until the 31st day to readmit the patient.

“If you are my patient, our goal should be to make you feel better,” Gheorghiade said. “This is potentially harming the patient.”

The most effective readmission date might vary from disease to disease, Gheorghiade said. The article cited a study showing 58 percent of heart failure readmissions come after 60 days. For a more acute condition, such as a broken leg, the readmission time might be shorter than 30 days, Gheorghiade said.

“The important remaining question is whether patients will benefit from this measure,” the study authors wrote. “Thus far, it appears that this metric has the potential to result in more harm than benefit for patients with heart failure.”

— Daniel Schlessinger