Now that patient outcomes and readmission rates are directly tied to reimbursements from the Centers for Medicare & Medicaid Services (CMS), one study suggests that factors beyond care providers’ control may be adversely affecting the agency’s goals. Recent research, which analyzed previous data on people who died or were readmitted within a short period of time after discharge, found that their social and/or financial environments may have a bearing on their success.
The new study, published in the Journal of General Internal Medicine, notes that a patient’s age, income, race, employment status and other social factors can play a role in outcomes and readmissions. The researchers analyzed the date from 20 pneumonia studies and 52 studies on heart failure.
Findings indicate that age, race, low income, unemployment and low education levels put pneumonia patients at a higher risk of readmission.
For discharged patients with heart failure, the risks most likely to lead to hospital readmission or death included age, race, insurance, marital status and risky behaviors. Proximity to a hospital was also linked to high risk of death for patients with heart failure.
While the study’s authors stress that more research is needed, they say doctors, case managers and discharge planners can use this type of information to anticipate which patients might be at high risk for readmission.
The researchers note that because CMS compares hospitals to 30-day mortality and readmission rates, having a social profile of at-risk patients can help hospitals provide better directed care to promote better patient outcomes.