Readmissions:  Hospital 30-Day Non-Index Readmission Risk Measure and Analysis

The Problem

Hospital 30-day readmission is widely recognized as a marker of care quality as well as a significant factor in rising healthcare costs.  How to reduce hospital 30-day readmission has gained increasing interests nationwide for the purpose of both reducing costs and improving quality.

The hospital readmission defined by CMS includes readmission to the same hospital as well as the readmission to a different hospital. For patients who are readmitted to a hospital other than the ones that their previous hospitalizations, it is likely that they will receive care from a different group of providers. Issues such as poor communication between hospitals and lack of sharing patient medical records have become barriers to continuity of care, which has led to patients not getting the needed care, receiving duplicate care, or suffering from medical errors.


To investigate the association between two types of patient groups classified by readmission types and their related hospital utilizations as well as identify potential factors that may help to predict high hospital utilization patients.


Several hospital utilization indicators are compared between two types of patient groups classified by the type of readmission that they experienced. In addition, several patient characteristics are examined to identify high hospital utilization patients using logistic regression. A Poisson regression model is used to exam the association between patient group types and hospital readmission rate controlled by patient characteristics.

Potential Impact

By providing an analysis of patient characteristics of those who tend to return to index versus non-index hospitals, this can provide hospitals with a place to start to both identify patients who might return and begin to develop strategies to promote better health outcomes.

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