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Reducing excess hospital readmissions: Does destination matter?

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  • Min Chen

    (Florida International University)

Abstract

Reducing excess hospital readmissions has become a high policy priority to lower health care spending and improve quality. The Affordable Care Act (ACA) penalizes hospitals with higher-than-expected readmission rates. This study tracks patient-level admissions and readmissions to Florida hospitals from 2006 to 2014 to examine whether the ACA has reduced readmission effectively. We compare not only the change in readmissions in targeted conditions to that in non-targeted conditions, but also changes in sites of readmission over time and differences in outcomes based on destination of readmission. We find that the drop in readmissions is largely owing to the decline in readmissions to the original hospital where they received operations or treatments (i.e., the index hospital). Patients readmitted into a different hospital experienced longer hospital stays. The results suggest that the reduction in readmission is likely achieved via both quality improvement and strategic admission behavior.

Suggested Citation

  • Min Chen, 2018. "Reducing excess hospital readmissions: Does destination matter?," International Journal of Health Economics and Management, Springer, vol. 18(1), pages 67-82, March.
  • Handle: RePEc:kap:ijhcfe:v:18:y:2018:i:1:d:10.1007_s10754-017-9224-x
    DOI: 10.1007/s10754-017-9224-x
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    References listed on IDEAS

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    1. Dennis J. Zhang & Itai Gurvich & Jan A. Van Mieghem & Eric Park & Robert S. Young & Mark V. Williams, 2016. "Hospital Readmissions Reduction Program: An Economic and Operational Analysis," Management Science, INFORMS, vol. 62(11), pages 3351-3371, November.
    2. Ashton, Carol M. & Wray, Nelda P., 1996. "A conceptual framework for the study of early readmission as an indicator of quality of care," Social Science & Medicine, Elsevier, vol. 43(11), pages 1533-1541, December.
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    Cited by:

    1. Md Saiful Islam & Md Sarowar Morshed & Gary J Young & Md Noor-E-Alam, 2019. "Robust policy evaluation from large-scale observational studies," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-19, October.

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    More about this item

    Keywords

    Thirty-day readmissions; Index hospital; Quality of care; Medicare;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L51 - Industrial Organization - - Regulation and Industrial Policy - - - Economics of Regulation
    • L88 - Industrial Organization - - Industry Studies: Services - - - Government Policy

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