Jason Sutherland
Finding ways to lower readmission rates for patients discharged from hospital could reduce unnecessary health-care spending and improve patient care, according to research by the Faculty of Medicine.
“Readmission rates in other countries are falling, but in Canada the rates are stable,” said Jason Sutherland, an Associate Professor in the Centre for Health Services and Policy Research in the School of Population and Public Health. “Reducing readmission rates is one of the most feasible ways to improve patient care and reduce health-care costs.”
Dr. Sutherland examined whether a program implemented in the U.S. in 2012 to reduce readmissions could work in B.C. The U.S. Medicare program’s Hospital Readmission Reduction Program (HRRP) penalizes hospitals financially for their readmission rates.
For the analysis, Sutherland and his colleagues used data on 18 B.C. hospitals’ readmission rates for three common conditions: heart attacks, heart failure and pneumonia. For a three-year study period between 2010 and 2013, the researchers calculated whether the hospitals had higher readmission rates than should be expected using a formula from the U.S. system. They found that 14 of the 18 hospitals had higher than expected readmission rates for at least one of the serious conditions – while some had high readmission rates for all three conditions.
According to the results, published recently in Healthcare Management Forum, readmissions cost the province approximately $13 million for the three health conditions over the three-year period, not including physician fees. Readmissions also tie up hospital beds and prevent other patients from accessing hospital care.
The researchers calculated the financial penalties that the hospitals would face under the HRRP. If the HRRP was applied in B.C., many hospitals faced a clawback of less than $40,000 and the largest penalty was $217,000.
While technically feasible in B.C., Sutherland said that the study shows the U.S. system is not the best option for the province because the financial impact would be too small to motivate hospitals to make changes. Instead Sutherland suggests that introducing new programs in hospitals to reduce readmissions would likely be more effective in improving patient care and reducing unnecessary spending.
“Canadian health care systems need to be making changes to get more value for health spending and to improve the quality of care patients receive,” he said.