Understanding the relationship between readmission and quality of hospital care in heart failure.
Understanding the relationship between readmission and quality of hospital care in heart failure.
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DOI：
10.1007/s11897-014-0209-5
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发表时间：
2014-12-01
影响因子：
--
通讯作者：
Joynt, Karen E
中科院分区：
文献类型：
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作者：
Gilstrap, Lauren Gray;Joynt, Karen E
心力衰竭（HF）的再入院率越来越被视为一项质量指标，并被用于确定报销率和惩罚表现不佳的医院。随着疾病模式从单一的急性发作转变为更多的慢性和退行性疾病，全国各地的卫生保健系统正在努力应对提供高质量护理的挑战，同时控制再入院率和支出。以心衰作为慢性疾病的典型例子，本文首先描述了再入院率的历史基础，以及它们如何成为医疗保健质量的主流指标。然后研究了医院质量和再入院率之间有争议的关系。本文探讨了几种降低再入院率的策略，包括出院计划和再入院减少计划，以及再入院率和死亡率之间的关系。讨论了重新接纳的主要驱动因素，并探讨了新的基于重新接纳的金融政策的影响。
Hospital readmission rates for heart failure (HF) are increasingly seen as a quality metric and are being used to define reimbursement rates and penalize underperforming hospitals. As disease patterns shift from single acute episodes of illness to more chronic and degenerative diseases, healthcare systems across the country are grappling with the challenge of providing quality care while simultaneously controlling both readmission rates and spending. Using HF as a prototypical example of chronic illness, this review begins by describing the historical underpinnings of readmission rates and how they have become a mainstream metric of healthcare quality. It then examines the controversial relationship between hospital quality and readmission rates. The paper examines several strategies to decrease readmission rates, including discharge planning and readmission reduction programs, as well as the relationship between readmission rates and mortality rates. The principal drivers of readmissions are discussed and the impact of new readmission-based financial policy is explored as well.