Blog | Wednesday, October 14, 2015

Readmissions for pneumonia not related to performance metrics


The Centers for Medicare and Medicaid Services now penalizes hospitals for high readmission rates. They assumed that good care would prevent readmissions. This story, which gives a link to the original article, demonstrates that readmissions have no apparent relationships to “quality of care.”

The physicians that I talk with all have assumed that we would have great difficulty decreasing readmission rates. This study supports that view.

We have difficulty understanding the belief that we can have a major impact on readmission through better care quality. We did not see any evidence supporting that belief. If we live in an era where we should follow the best available evidence, then why do we have such payment measures.

Will this study change anything? I doubt it, because the rules are made outside an understanding of medical evidence. The physicians with whom I talk find this trend frustrating and difficult to understand. Just because you can measure something does not mean that the measures relate to the complex process that defines patient care.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.