Format

Send to

Choose Destination
See comment in PubMed Commons below
Health Policy. 2015 Mar;119(3):264-73. doi: 10.1016/j.healthpol.2014.12.009. Epub 2014 Dec 15.

A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States.

Author information

1
Manchester Centre for Health Economics, University of Manchester, UK; COHERE - Centre of Health Economics Research, Department of Business and Economics, University of Southern Denmark, Denmark.
2
COHERE - Centre of Health Economics Research, Department of Business and Economics, University of Southern Denmark, Denmark. Electronic address: mbe@sam.sdu.dk.
3
Department of Health Care Management, Berlin University of Technology, Germany; European Observatory on Health Systems and Policies, Brussels, Belgium.

Abstract

Hospital readmissions receive increasing interest from policy makers because reducing unnecessary readmissions has the potential to simultaneously improve quality and save costs. This paper reviews readmission policies in Denmark, England, Germany and the United States (Medicare system). The suggested roadmap enables researchers and policy makers to systematically compare and analyse readmission policies. We find considerable differences across countries. In Germany, the readmission policy aims to avoid unintended consequences of the introduction of DRG-based payment; it focuses on readmissions of individual patients and hospitals receive only one DRG-based payment for both the initial and the re-admission. In Denmark, England and the US readmission policies aim at quality improvement and focus on readmission rates. In Denmark, readmission rates are publicly reported but payments are not adjusted in relation to readmissions. In England and the US, financial incentives penalise hospitals with readmission rates above a certain benchmark. In England, this benchmark is defined through local clinical review, while it is based on the risk-adjusted national average in the US. At present, not enough evidence exists to give recommendations on the optimal design of readmission policies. The roadmap can be a tool for systematically assessing how elements of other countries' readmission policies can potentially be adopted to improve national policies.

KEYWORDS:

Avoidable readmissions; Hospital reimbursement; Provider payment; Readmission policies; Readmission rates

PMID:
25547401
DOI:
10.1016/j.healthpol.2014.12.009
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center