30-Day Unplanned Readmission Rate - Pneumonia

Identifying Attributes

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

Defining Attributes

Definition

A hospital-level 30-day, all-cause, risk-standardised readmission rate (RSRR) for patients age 65 and older discharged from the hospital with either a principal discharge diagnosis of pneumonia (including aspiration pneumonia) or a principal discharge diagnosis of sepsis (not severe sepsis) with a secondary diagnosis of pneumonia (including aspiration pneumonia) coded as present on admission (POA).

Numerator

Inpatient acute care admissions for any cause, with the exception of certain planned readmissions, within 30 days from the date of discharge from the index admission for patients discharged from the hospital with a principal diagnosis of pneumonia, including aspiration pneumonia or a principal diagnosis of sepsis (not severe sepsis) with a secondary diagnosis of pneumonia (including aspiration pneumonia) coded as POA and no secondary diagnosis of severe sepsis.

Denominator

Admissions for patients aged 65 years and older discharged from the hospital with a principal discharge diagnosis of pneumonia, including aspiration pneumonia or a principal discharge diagnosis of sepsis (not severe sepsis) with a secondary discharge diagnosis of pneumonia (including aspiration pneumonia) coded as POA and no secondary discharge diagnosis of severe sepsis; and with a complete claims history for the 12 months prior to admission.

Exclusions

Excludes index admissions for patients: • Discharged against medical advice • Without at least 30 days post-discharge enrolment in FFS Medicare (in the case of patients who are not VA beneficiaries) • Admitted within 30 days of a prior index admission for pneumonia

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

By hospital and state.

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims data, confidential Hospital-Specific Reports (HSRs) sent to hospitals by CMS

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

Hospital Readmissions Reduction Program data is displayed at data.cms.gov

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

Source and Reference Attributes

Technical Specifications
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)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
23 July 2025