Hospital Teaching Intensity Affects Readmission Rates
With changes to hospital payment models, findings have financial implications for safety-net institutions
WEDNESDAY, June 26 (HealthDay News) -- Hospital teaching intensity significantly affects readmission rates for the most common inpatient diagnoses, particularly for safety-net hospitals, according to a study published in the July issue of Medical Care.
Stephanie K. Mueller, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues utilized the 2008 Hospital Quality Alliance and 2007 American Hospital Association databases to assess a national sampling of 2,418 hospitals for which data on teaching intensity (resident-to-bed ratio) and quality-of-care process measures were available. Additionally, 30-day risk-adjusted readmission and mortality rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia were analyzed.
The researchers found that quality-of-care process measures for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia were similar for all hospitals. Increasing hospital teaching intensity was significantly associated with improved risk-adjusted mortality for AMI and CHF, but higher risk-adjusted readmission rates for all three conditions, compared to nonteaching hospitals. There were particularly high readmission rates for AMI and CHF for high teaching intensity hospitals with larger Medicaid populations (safety-net institutions).
"Our findings suggest that high teaching intensity and safety-net institutions may be disproportionately affected by upcoming changes in hospital payment models," the authors write.
Abstract (http://journals.lww.com/lww-medicalcare/Abstract/2013/07000/Impact_of_Hospital_Teaching_Intensity_on_Quality.2.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/lww-medicalcare/Abstract/2013/07000/Impact_of_Hospital_Teaching_Intensity_on_Quality.2.aspx )