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Am Heart J. 2019 Mar;209:63-67. doi: 10.1016/j.ahj.2018.12.002. Epub 2018 Dec 7.

Comparison of the change in heart failure readmission and mortality rates between hospitals subject to hospital readmission reduction program penalties and critical access hospitals.

Author information

1
Stanford University School of Medicine, Stanford, CA. Electronic address: Ats114@stanford.edu.
2
Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.

Abstract

BACKGROUND:

The Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure.

METHODS:

We compared heart failure readmission and mortality rates in hospitals exposed to HRRP financial penalties with critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare.

RESULTS:

After HRRP introduction, CAHs experienced a 0.60% annual decrease (95% CI: -0.61 to -0.59%) in heart failure readmissions. HRRP-exposed hospitals experienced an additional 0.13% annual decrease (95% CI: -0.14 to -0.12%) compared with CAHs. The association between HRRP penalties and mortality varied with model specifications.

CONCLUSIONS:

Using CAHs as a control group, we found the introduction of financial penalties was only associated with modest reductions in readmissions and an uncertain association with mortality. Cluster-randomized rollouts of health care policy interventions will allow us to better evaluate the impact of our interventions.

PMID:
30685676
DOI:
10.1016/j.ahj.2018.12.002
[Indexed for MEDLINE]

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