Plan All-Cause Readmissions
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
For members 18 years of age and older, the number of acute inpatient and observation stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days and the predicted probability of an acute readmission.
Numerator
Denominator
Exclusions
Use of Risk Adjustment
Risk Adjustments
The observed rate and predicted probability is used to calculate a calibrated observed-to-expected ratio that assesses whether plans had more, the same or less readmissions than expected, while accounting for incremental improvements across all plans over time. The observed-to-expected ratio is multiplied by the readmission rate across all health plans to produce a risk-standardised rate which allows for national comparison.
Stratifications
By organisation (Medicare HMO, Medicare PPO).
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Healthcare Effectiveness Data and Information Set (HEDIS)
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
HEDIS measures are reported on by the NCQA in a variety of specialised annual reports, but may also be utilised and reported on by other organisations with permission from NCQA.