Hospital Accountability and Population Health: Lessons From Measuring Readmission Rates
Authors: Stephen F. Jencks
Journal: Annals of Internal Medicine (2013)

Ideas and OpinionsNovember 5, 2013Hospital Accountability and Population Health: Lessons From Measuring Readmission RatesStephen F. Jencks, MD, MPH and Jane E. Brock, MD, MSPHStephen F. Jencks, MD, MPHFrom Baltimore, Maryland, and CFMC, Englewood, Colorado. and Jane E. Brock, MD, MSPHFrom Baltimore, Maryland, and CFMC, Englewood, Colorado.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-9-201311050-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Patient Protection and Affordable Care Act (1) and the National Strategy for Quality Improvement in Health Care (2) ask the health care community to broaden its vision of care and its traditional focus on the care of individuals to include improving population health. Measuring the success of this vision requires population-based clinical performance measures of the burden of disease and success of care for the whole population, regardless of where, or even whether, care is delivered. By contrast, almost all existing measures are provider-based and intended to compare and hold providers accountable for an episode of care.Population usually ...References1. National Strategy for Quality Improvement in Health Care. 42 U.S.C. Chapter 6A. Subchapter II. Part S. Subpart i. § 280j (2011). Google Scholar2. U.S. Department of Health and Human Services. Report to Congress: National Strategy for Quality Improvement in Health Care, March 2011. Washington, DC: U.S. Department of Health and Human Services; 2011. Accessed at www.ahrq.gov/workingforquality/nqs/nqs2011annlrpt.htm on 16 September 2013. Google Scholar3. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates. Fed Reg. 2012;77:27870-9. Accessed at www.gpo.gov/fdsys/pkg/FR-2012-05-11/pdf/2012-9985.pdf on 16 September 2013. Google Scholar4. Brock J, Mitchell J, Irby K, Stevens B, Archibald T, Goroski A, et al. Care Transitions Project Team. Association between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries. JAMA. 2013;309:381-91. [PMID: 23340640] CrossrefMedlineGoogle Scholar5. Jencks SF, Williams MV, and Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418-28. [PMID: 19339721] CrossrefMedlineGoogle Scholar6. Berenson RA, Paulus RA, and Kalman NS. Medicare's readmissions-reduction program—a positive alternative. N Engl J Med. 2012;366:1364-6. [PMID: 22455754] CrossrefMedlineGoogle Scholar7. Gorodeski EZ, Starling RC, and Blackstone EH. Are all readmissions bad readmissions? [Letter]. N Engl J Med. 2010;363:297-8. [PMID: 20647209] CrossrefMedlineGoogle Scholar8. Epstein AM, Jha AK, and Orav EJ. The relationship between hospital admission rates and rehospitalizations. N Engl J Med. 2011;365:2287-95. [PMID: 22168643] CrossrefMedlineGoogle Scholar9. Krumholz HM, Lin Z, Keenan PS, Chen J, Ross JS, Drye EE, et al. Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia. JAMA. 2013;309:587-93. [PMID: 23403683] CrossrefMedlineGoogle Scholar10. Medicare.gov. Frequently Asked Questions: CMS Publicly Reported Risk-Standardized Outcome Measures May 16, 2013. Accessed at www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1163010398556 on 16 September 2013. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Baltimore, Maryland, and CFMC, Englewood, Colorado.Disclaimer: The contents presented do not reflect Centers for Medicare & Medicaid Services policy (PM-4010-132 CO 2012).Financial Support: Dr. Brock was partially supported by the Integrating Care for Populations & Communities National Coordinating Center at CFMC with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0879.Corresponding Author: Stephen F. Jencks, MD, MPH, 8 Midvale Road, Baltimore, MD 21210; e-mail, [email protected].Current Author Addresses: Dr. Jencks: 8 Midvale Road, Baltimore, MD 21210.Dr. Brock: CFMC, 23 Inverness Way East, Englewood, CO 80112.Author Contributions: Conception and design: S.F. Jencks, J.E. Brock.Analysis and interpretation of the data: S.F. Jencks, J.E. Brock.Drafting of the article: S.F. Jencks, J.E. Brock.Critical revision of the article for important intellectual content: S.F. Jencks, J.E. Brock.Final approval of the article: S.F. Jencks, J.E. Brock.Statistical expertise: S.F. Jencks.Administrative, technical, or logistic support: S.F. Jencks.Collection and assembly of data: S.F. Jencks. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics November 5, 2013Volume 159, Issue 9Page: 629-630KeywordsDeath ratesFallsHealth care providersHeart failureHospitalizationsMedicareMyocardial infarctionPatientsPneumoniaPrevention, policy, and public healthQuality improvementSpecificityVision ePublished: 5 November 2013 Issue Published: November 5, 2013 PDF DownloadLoading ...