Hospital readmissions within 30 days of discharge may not be a good way of judging the quality of care hospitals provide, a new study suggests.

Seven days may be more like it.

According to a new study published in the journal Health Affairs, the impact of the quality of care a hospital provides appears to be most evident immediately upon patients’ discharge from the hospital.

Further, the study suggests,

… most readmissions after the seventh day postdischarge were explained by community- and household-level factors beyond hospitals’ control.

The researchers’ conclusion?

Shorter intervals of seven or fewer days might improve the accuracy and equity of readmissions as a measure of hospital quality for public accountability.

health affairsThe findings call into question the approach employed by Medicare through its’ hospital readmissions reduction program.

NAUH has long opposed the manner in which Medicare’s readmissions reduction program is constructed and has urged the Centers for Medicare & Medicaid Services to revise it by taking into consideration the distinct challenges private safety-net hospitals face when applying its 30-day standard – the very kind of challenges, such as community and household factors, cited in the study. Earlier this year NAUH endorsed legislation in Congress – H.R. 1343 and S. 688, the Establishing Beneficiary Equity in the Hospital Readmissions Program Act – and in a letter to CMS calling for change in the program as well.

To learn more about how the study was performed and what its implications might be, go here to see the Health Affairs study “Rethinking Thirty-Day Hospital Readmissions: Shorter Intervals Might Be Better Indicators Of Quality Of Care.’