Estimates a hospital-level, 30-day risk-standardised readmission rate for patients discharged from the hospital after an elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA).

30-day, all-cause readmissions for patients discharged from the hospital after an elective primary THA and/or TKA. This measure looks for a dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days.

Admissions for patients aged 65 or over; discharged alive; having a qualifying elective primary THA and/or TKA procedure during the index admission; and enrolled in Medicare fee-for-service Part A and Part B for the 12 months prior to the date of admission and Part A during the index admission.

Index admissions without at least 30 days of post-discharge enrolment in Medicare fee-for-service (in the case of patients who are not VA beneficiaries); admitted for the index procedure and subsequently transferred to another acute care facility; THA/TKA admissions within 30 days of discharge from a prior THA/TKA index admission; discharged against medical advice; with more than two THA/TKA procedure codes during the index admission; with a principal diagnosis code of COVID-19 or with a secondary diagnosis code of COVID-19 coded as present on admission on the index admission claim.

Hierarchical logistic regression is used to adjust for differences in hospital case mix (age and clinical status of the patient, accounted for by adjusting for comorbidities) and to account for the clustering of patients within a hospital. The measure calculates a risk-standardised ratio of the number of predicted readmissions to the number of expected readmissions. This ratio is multiplied by the national observed readmission rate to get the risk-standardised readmission rate (RSRR).

Medicare fee-for-service (FFS) claims data.

Hospital Readmission Reduction Program (CMS and Providers) CMS Care Compare - Hospitals and Provider Data Catalogue (Publicly reported) Contributes to Overall Hospital Quality Star Rating.

Crespin DJ, Whaley C. The effect of hospital discharge price increases on publicly reported measures of quality. Health Serv Res. 2023 Feb;58(1):91-100. doi: 10.1111/1475-6773.14040. Epub 2022 Aug 9. PMID: 35872595; PMCID: PMC9836939. Goldberg EM, Morphis B, Youssef R, Gardner R. An analysis of diagnoses that drive readmission: What can we learn from the hospitals in Southern New England with the highest and lowest readmission performance? R I Med J (2013). 2017 Aug 1;100(8):23-28. PMID: 28759896; PMCID: PMC5666576. www.cms.gov/medicare/quality/value-based-programs/hospital-readmissions data.cms.gov/provider-data/topics/hospitals/measures-and-current-data-collection-periods data.cms.gov/provider-data/topics/hospitals/overall-hospital-quality-star-rating

cmit.cms.gov/cmit/#/MeasureView?variantId=668&sectionNumber=1 www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/measure-methodology