Hospital-Wide 30-Day, All-Cause, Risk-Standardised Readmission Rate Following Hospitalisation

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Hospital Inpatient Quality Reporting Program
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Hospitalisation

Defining Attributes

Definition

Hospital-level, 30-day risk-standardised readmission rate for patients discharged from the hospital after an admission for any eligible condition. The index admission is the eligible hospitalisation to which the readmission outcome is attributed.

Numerator

30-day, all-cause readmissions - dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days. If a patient has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, only the first one is counted as a readmission.

Denominator

Admissions that meet all of the following criteria: aged 65 or over; discharged alive; and not transferred to another acute care facility.

Exclusions

Index admissions for patients: 1. Admitted to a PPS-exempt cancer hospital; 2. Without at least 30 days of post-discharge enrolment in Medicare fee-for-service (in the case of patients who are not VA beneficiaries); 3. Admitted for primary psychiatric diagnosis; 4. Admitted for rehabilitation; 5. Admitted for medical treatment of cancer; 6. Discharged against medical advice; 7. 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.

Use of Risk Adjustment
Yes
Risk Adjustments

Adjusted both for case mix differences (clinical status of the patient, accounted for by adjusting for comorbidities) and service mix differences (the types of conditions/procedures cared for by the hospital, accounted for by adjusting for the discharge condition category).

Stratifications

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Medicare administrative claims and enrolment information.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

Hospital Inpatient Quality Reporting Program (CMS and Providers) CMS Provider Compare and CMS Care Compare - Hospitals (Publicly reported) Contributes to Overall Hospital Star Quality Rating.

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025