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Hospital re-admissions

What are hospital readmissions?
Medical research has shown that hospital readmission rates are an important way to measure quality of care. Most hospital patients come to the hospital, undergo surgery or receive treatment for a medical condition, then go home when they have recovered. Sometimes, however, patients need to return to the hospital after going home.

By looking at the percentage of patients who return to the hospital within 30 days of going home, we can learn about numerous important issues. Readmission rates can tell us if patients' treatments are working well, whether they are being sent home at the right time, and whether patients understand how to care for themselves once they return home.

Readmission rates are usually measured in one of two ways: all-cause readmissions or related-cause readmissions.

  • Related-cause readmissions track whether patients return to the hospital within 30 days for treatments related to their original hospital stay. For example, a pneumonia patient who was sent home from the hospital might have to return if her pneumonia symptoms returned.
  • All-cause readmissions track whether patients return to the hospital for any reason within 30 days of being treated, regardless of why they are returning to the hospital. For example, a person who was treated for pneumonia may return after suffering a heart attack.

MU Health Care focuses on all-cause readmissions. This is a higher standard, and we use it as a way to ensure we are providing the highest quality care.

What are we doing to prevent readmissions?
Not all hospital readmissions can or should be prevented. For example, sometimes a patient has a complex medical condition that requires a patient be hospitalized multiple times for several surgeries.

To prevent unnecessary readmissions, experts at University of Missouri Health Care treat patients with the latest techniques based on medical evidence. We also follow strict standards to determine when patients are ready to return home. Once a patient is ready to go home, our physicians, nurses, therapists, pharmacists and other professionals teach them about their medications and how to care for themselves after leaving the hospital.

We have implemented additional quality improvement programs designed to reduce the likelihood of patients' needing to be readmitted to the hospital.

In 2010, MU Health Care implemented a program of post-discharge callbacks. A few days after patients go home from the hospital, a registered nurse calls each patient to see how he is doing and answer any questions he may have.

In 2011, we began evaluating certain health conditions - including heart attack, heart failure and pneumonia - looking for ways to further reduce the occurrence of any readmissions that can be prevented.

What can patients and families do to help?
One of the most important ways to prevent readmission to the hospital is by being prepared to care for yourself or your loved one at home. This guide from the Agency for Healthcare Research and Quality can help you organize your care.

We encourage patients and family members to print this guide, fill it out with the help of your health care team and use it to prepare for caring for yourself of your loved one at home: http://www.ahrq.gov/qual/goinghomeguide.pdf.

How are we doing?
University of Missouri Health Care's all-cause hospital patient readmission rates historically have been near or below average readmission rates compared to our benchmark of other academic medical centers from an organization called the University HealthSystem Consortium (UHC).

In 2010, when we began our post-discharge callbacks to check on patients after they had gone home, our readmission rates continued to drop. For our most recent time period, from October to December 2011, our overall readmission rate was 12.12 percent, compared to the average UHC rate of 13.64 percent.

For the above graph: Lower ↓ performance is better.

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