Tracking the number of patients who experience unplanned readmissions to a hospital after a previous hospital stay is another category of data used to judge the quality of hospital care. One example of an unplanned readmission would be someone who is readmitted to the hospital for a surgical wound infection that occurred after his or her initial hospital stay.
It is important to note that unplanned hospital readmissions may or may not be related to the previous visit, and some unplanned readmissions are not preventable. Whatever the reason, insurance companies and other payors sometimes view unplanned hospital readmissions as wasteful spending.
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How hospital readmissions are measured and evaluated
Depending on the reporting source, readmissions can be defined as any admission to the same hospital occurring within seven, 15 or 30 days after discharge from the initial visit. Mayo Clinic defines hospital readmission as patient admission to a hospital within 30 days after being discharged from an earlier hospital stay. The standard benchmark used by the Centers for Medicare & Medicaid Services (CMS) is the 30-day readmission rate. Rates at the 80th percentile or lower are considered optimal by CMS.
Patients transferred to another hospital for longer term care will not count as a readmission. A hospital's readmission rate is calculated by dividing the total number of patients readmitted within seven days of discharge by the total number of hospital discharges.
Hospital readmissions at Mayo Clinic
Mayo Clinic has initiated several quality improvement efforts to focus on the care of our hospital patients while in the hospital as well as improvement efforts focused on effective and safe discharge plans. Good discharge plans can help reduce the rate of unplanned readmissions by giving patients the care instructions they need after a hospital stay and by helping patients recognize symptoms that may require immediate medical attention.