Medicare beneficiaries living in the most disadvantaged neighborhoods are more likely than others to require readmission to the hospital for problems associated with congestive heart failure, pneumonia, or myocardial infarction.

This is one of the findings in a new Annals of Internal Medicine study titled “Neighborhood Socioeconomic Disadvantage and 30-Day Rehospitalization:  A Retrospective Cohort Study.”

The study, based on data from 2004 through 2009, compared Medicare readmission rates in different geographic areas using what is called a validated area deprivation index that measures relative social determinants of health to identify the most disadvantaged areas.  Researchers concluded that

The 30-day rehospitalization rate did not vary significantly across the least disadvantaged 85% of neighborhoods, which had an average rehospitalization rate of 21%. However, within the most disadvantaged 15% of neighborhoods, rehospitalization rates increased from 22% to 27% with worsening ADI.

These findings confirm the argument that the National Association of Urban Hospitals has been making ever since Medicare’s hospital readmissions reduction program was introduced:  that the low-income Medicare patients many private safety-net hospitals serve are fundamentally more difficult to treat than the typical hospital patient and that the readmissions reduction program needs to be risk-adjusted to account for this difference.

The Annals of Internal Medicine study is just the latest academic research that confirms NAUH’s contention about Medicare’s readmissions reduction program.

Find the study here, on the web site of the Annals of Internal Medicine.