This measure estimates a hospital-level, risk-standardised readmission rate (RSSR) of unplanned, all-cause readmission within 30 days of hospital discharge for any eligible condition. The measure reports a single summary RSRR, derived from the volume-weighted results of five different models, one for each of the following specialty cohorts based on groups of discharge condition categories or procedure categories: surgery/gynaecology, general medicine, cardiorespiratory, cardiovascular, and neurology.

The outcome for this measure is 30-day readmission. Readmission is defined as an inpatient acute care admission for any cause, with the exception of certain planned readmissions, within 30 days from the date of discharge from an eligible index admission. If a patient has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, only one is counted as a readmission. The measure looks for a dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days. However, if the first readmission after discharge is considered planned, any subsequent unplanned readmission is not counted as an outcome for that index admission because the unplanned readmission could be related to care provided during the intervening planned readmission rather than during the index admission.

The measure includes admissions for patients that meet all of the following inclusion criteria: 1. Enrolled in Medicare FFS Part A for the 12 months prior to the date of admission and during the index admission; 2. Aged 65 or over; 3. Discharged alive from a non-federal short-term acute care hospital; 4. Not transferred to another acute care facility.

Index admissions for patients: 1. Admitted to Prospective Payment System (PPS)-exempt cancer hospitals; 2. Without at least 30 days post-discharge enrolment in Medicare FFS; 3. Discharged against medical advice (AMA); 4. Admitted for primary psychiatric diagnoses; 5. Admitted for rehabilitation; or 6. Admitted for medical treatment of cancer.

Adjusted for age and comorbidities (Condition Categories) as well as cohort specific variables.

Claims Data and Electronic Clinical Data.

Hospital Inpatient Quality Reporting Program (CMS and Providers).

cmit.cms.gov/cmit/#/MeasureView/?variantId=4597&sectionNumber=1 data.cms.gov/provider-data/topics/hospitals/measures-and-current-data-collection-periods

www.cms.gov/files/document/hybrid-hospital-wide-readmission-measure-electronic-health-record-extracted-risk-factors.pdf-0