Evidence map›Paper›PMID 25379675›Full record

SynthesisPloS one2014

Is the readmission rate a valid quality indicator? A review of the evidence.

Claudia Fischer, Hester F Lingsma, Perla J Marang-van de Mheen, Dionne S Kringos, Niek S Klazinga, Ewout W Steyerberg

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 119 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
119citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

119 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Substance Use Disorder Treatment Outcomes: Methodological Overview of Metrics and Criteria.International journal of methods in psychiatric research · 2025
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  13. Comparing home-based and institutional rehabilitation for community-dwelling hip fracture patients: a matched cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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59 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Claudia FischerDepartment of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, the Netherlands.
Hester F LingsmaDepartment of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, the Netherlands.
Perla J Marang-van de MheenDepartment of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.
Dionne S KringosDepartment of Public Health, Amsterdam Medical Centre, Amsterdam, the Netherlands.
Niek S KlazingaDepartment of Public Health, Amsterdam Medical Centre, Amsterdam, the Netherlands.
Ewout W SteyerbergDepartment of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHospital readmission rates are increasingly used for both quality improvement and cost control. However, the validity of readmission rates as a measure of quality of hospital care is not evident. We aimed to give an overview of the different methodological aspects in the definition and measurement of readmission rates that need to be considered when interpreting readmission rates as a reflection of quality of care.

methodsWe conducted a systematic literature review, using the bibliographic databases Embase, Medline OvidSP, Web-of-Science, Cochrane central and PubMed for the period of January 2001 to May 2013.

resultsThe search resulted in 102 included papers. We found that definition of the context in which readmissions are used as a quality indicator is crucial. This context includes the patient group and the specific aspects of care of which the quality is aimed to be assessed. Methodological flaws like unreliable data and insufficient case-mix correction may confound the comparison of readmission rates between hospitals. Another problem occurs when the basic distinction between planned and unplanned readmissions cannot be made. Finally, the multi-faceted nature of quality of care and the correlation between readmissions and other outcomes limit the indicator's validity.

conclusionsAlthough readmission rates are a promising quality indicator, several methodological concerns identified in this study need to be addressed, especially when the indicator is intended for accountability or pay for performance. We recommend investing resources in accurate data registration, improved indicator description, and bundling outcome measures to provide a more complete picture of hospital care.

Indexed as

Patient ReadmissionHospitalsHumansLength of StayQuality Control

Identifiers

PMID25379675
PMCPMC4224424

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.