Readmissions Reduction Efforts May Lead To Increased Mortality Rates

A new study on the implementation of the Hospital Readmission Reduction Program (HRRP) found an uptick in deaths of patients who were initially admitted for heart failure. Conducted by UCLA and Harvard researchers, the study is published in JAMA Cardiology.

The observational study examined the records of over 100,000 Medicare patients who were hospitalized for heart failure, covering 416 healthcare facilities across the U.S. The records were taken from a time span beginning January 1, 2006 and ending December 31, 2014.

Researchers found the HRRP, begun in 2010, achieved the desired outcome of reduced readmission rates. The 30-day risk-adjusted readmission rate was at 20 percent before HRRP implementation, then dropped to 18.4 percent after the program got underway.

Troublingly, the researchers found that the mortality rate of those heart failure patients was also impacted. The 30-day risk-adjusted mortality rate went from 7.2 percent to 8.6 percent with the introduction of the HRRP.

Taking the numbers to a year out saw a similar reduction in readmission rates (57.2 percent to 56.3) and a yet more striking jump in the mortality rate (31.3 percent to 36.3 percent).

Ashish Jha, a physician and health policy professor at Harvard University, told The Wall Street Journal that the the HRRP rules and corresponding financial penalties may be dissuading healthcare providers from putting some ailing patients in hospital beds, where they can get the care they need.

“Most people would not want to be readmitted, but it’s not a fate worse than death,” Jha said.

Image credit: Brett Coomer/Houston Chronicle via AP