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- Title
Changes in coding of pneumonia and impact on the Hospital Readmission Reduction Program.
- Authors
Buxbaum, Jason D.; Lindenauer, Peter K.; Cooke, Colin R.; Nuliyalu, Ushapoorna; Ryan, Andrew M.
- Abstract
<bold>Objective: </bold>To evaluate whether changes in diagnosis assignment explain reductions in 30-day readmission for patients with pneumonia following the Hospital Readmission Reduction Program (HRRP).<bold>Data Sources: </bold>100 percent MedPAR, 2008-2015.<bold>Study Design: </bold>Retrospective cohort study of Medicare discharges in HRRP-eligible hospitals. Outcomes were 30-day readmission rates for pneumonia under a "narrow" definition (used for the HRRP until October 2015; n = 2 288 644) and a "broad" definition that included certain diagnoses of sepsis and aspiration pneumonia (used since October 2015; n = 3 618 215). We estimated changes in 30-day readmissions in the pre-HRRP period (January 2008-March 2010), the HRRP implementation period (April 2010-September 2012), and the HRRP penalty period (October 2012-June 2015).<bold>Principal Findings: </bold>Under the narrow definition, adjusted annual readmission rates changed by +0.07 percentage points (pp) during the pre-HRRP period (95% CI: -0.03 pp, +0.18 pp), -1.07 pp during HRRP implementation (95% CI: -1.15 pp, -0.99 pp), and -0.09 pp during the penalty period (95% CI: -0.18 pp, -0.00 pp). Under the broad definition, 30-day readmissions changed by +0.21 pp during the pre-HRRP period (95% CI: +0.12 pp, +0.30 pp), -1.28 pp during HRRP implementation (95% CI: -1.35 pp, -1.21 pp), and -0.09 pp during the penalty period (95% CI: -0.16 pp, -0.02 pp).<bold>Conclusions: </bold>Changes in the coding of inpatient pneumonia admissions do not explain readmission reduction following the HRRP.
- Subjects
PATIENT readmissions; PNEUMONIA; ASPIRATION pneumonia; MEDICAL coding
- Publication
Health Services Research, 2019, Vol 54, Issue 6, p1326
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13207