“Risk-standardized mortality rates and readmission rates were not associated for patients admitted with an acute myocardial infarction or pneumonia and were only weakly associated, within a certain range, for patients admitted with heart failure,” according to study results in JAMA.
To investigate the relationship between hospital risk-standardized mortality rates (RSMRs) and risk-standardized-readmission rates (RSRRs) — overall and within subgroups — researchers used Medicare hospital inpatient, outpatient, and physician Standard Analytical Files to identify admissions, readmissions, and inpatient and outpatient diagnosis codes.
In total, they analyzed nearly 3 million hospital admissions.
The team found that average RSMRs and RSRRs, respectively, were 16.60% and 19.94% for heart attack, 11.17% and 24.56% for heart failure, and 11.64 % and 18.22% for pneumonia.
The correlations between RSMRs and RSRRs were 0.03 for acute myocardial infarction, -0.17 for heart failure, and 0.002 for pneumonia. In subgroup analyses, the correlations between RSMRs and RSRRs did not differ substantially in any of the subgroups of hospital types.
“In a national study of the CMS publicly reported outcomes measures, we failed to find evidence that a hospital’s performance on the measure for 30-day RSMR is strongly associated with performance on 30-day RSRR,” the authors conclude.
“These findings should allay concerns that institutions with good performance on RSMRs will necessarily be identified as poor performers on their RSRRs. For AMI and pneumonia, there was no discernible relationship, and for HF, the relationship was only modest and not throughout the entire range of performance. At all levels of performance on the mortality measures, we found both high and low performers on the readmission measures.”