Tracking the number of patients who experience unplanned readmissions to a hospital after a previous hospital stay is one category of data used to evaluate 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's important to note that unplanned hospital readmissions may or may not be related to the previous visit, and some unplanned readmissions aren't preventable. Whatever the reason, insurance companies and other payers sometimes view unplanned hospital readmissions as wasteful spending.
How hospital readmissions are measured and evaluated
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 won't count as a readmission.
Nov. 08, 2019