Abstract
Objective
To examine whether there are differences in inpatient rehabilitation facilities' (IRFs')
all-cause 30-day postdischarge hospital readmission rates vary by organizational characteristics
and geographic regions.
Design
Observational study.
Setting
IRFs.
Participants
Medicare fee-for-service beneficiaries discharged from all IRFs nationally in 2013
and 2014 (N = 1166 IRFs).
Interventions
Not applicable.
Main Outcome Measures
We applied specifications for an existing quality measure adopted by Centers for Medicare
& Medicaid Services for public reporting that assesses all-cause unplanned hospital
readmission measure for 30 days postdischarge from inpatient rehabilitation. We estimated
facility-level observed and risk-standardized readmission rates and then examined
variation by several organizational characteristics (facility type, profit status,
teaching status, proportion of low-income patients, size) and geographic factors (rural/urban,
census division, state).
Results
IRFs’ mean risk-standardized hospital readmission rate was 13.00%±0.77%. After controlling
for organizational characteristics and practice patterns, we found substantial variation
in IRFs' readmission rates: for-profit IRFs had significantly higher readmission rates
than did not-for-profit IRFs (P<.001). We also found geographic variation: IRFs in the South Atlantic and South Central
census regions had the highest hospital readmission rates than did IRFs in New England
that had the lowest rates.
Conclusions
Our findings point to variation in quality of care as measured by risk-standardized
hospital readmission rates after IRF discharge. Thus, monitoring of readmission outcomes
is important to encourage quality improvement in discharge care planning, care transitions,
and follow-up.
Keywords
List of abbreviations:
CMS (Centers for Medicare & Medicaid Services), FFS (Fee-for-service), IRF (Inpatient rehabilitation facility), PAC (Post-acute care), RSRR (Risk-standardized readmission rate)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 21, 2017
Footnotes
Supported in part by internal funding at RTI International. The statements contained in this article are solely those of the authors. The authors assume responsibility for the accuracy and completeness of the information contained in this article.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
