Hospitals in pursuit of excellence

Community Factors Substantially Influence Readmission Rates

This article found that county characteristics are independently associated with higher hospital readmission rates, the strongest being measures of access to care.

HSR reports that after accounting for patient-risk factors and community socioeconomic factors, as well as accounting for hospital characteristics and location, a substantial amount of readmission rate variation is explained by primary care access and the quality of nursing homes. 

The authors of the article, “Community Factors and Hospital Readmission Rates,” reported on 4,073 hospitals that publicly reported 30-day readmission rates for patients discharged with acute myocardial infarction, heart failure or pneumonia from 2007-2010. They found that 58 percent to of national variation in hospital readmission rates was explained by the county in which the hospital was located.

They applied the hospital data with county records to conclude that local factors such as income and employment levels, physician mix and nursing home quality explain nearly half of the variations. The authors suggest various community-based readmission reduction strategies that hospitals could employ to combat higher readmission rates in the future.