Observational studyBMJ open2017
Trends in readmission rates for safety net hospitals and non-safety net hospitals in the era of the US Hospital Readmission Reduction Program: a retrospective time series analysis using Medicare administrative claims data from 2008 to 2015.
Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal.BMC health services research · 2021Pooled it
- Article
- What works to reduce socioeconomic inequalities in hospitalisations and readmissions? Systematic review of the equity impacts of population-level, health service and integrative interventions.BMJ public health · 2025Article
- Article
- Independent Associations of Neighborhood Deprivation and Patient-level Social Determinants of Health with Textbook Outcomes after Inpatient Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Association of Insurance Type With Inpatient Surgery 30-Day Complications and Costs.The Journal of surgical research · 2023Article
- Readmissions performance and penalty experience of safety-net hospitals under Medicare's Hospital Readmissions Reduction Program.BMC health services research · 2022Article
- Hospital value-based payment programs and disparity in the United States: A review of current evidence and future perspectives.Frontiers in public health · 2022Review
- Factors Associated With Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid.JAMA health forum · 2022Article
- Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018.International journal of environmental research and public health · 2021Observational
- Association of Socioeconomic Area Deprivation Index with Hospital Readmissions After Colon and Rectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Improving evidence-based grouping of transitional care strategies in hospital implementation using statistical tools and expert review.BMC health services research · 2021Review
- Trends in the quality and cost of inpatient surgical procedures in the United States, 2002-2015.PloS one · 2021Article
- Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis.Journal of general internal medicine · 2020Article
- The Financial Impact of an Avoided Readmission for Teaching and Safety-Net Hospitals Under Medicare's Hospital Readmission Reduction Program.Medical care research and review : MCRR · 2020Article
- Increased 30-day readmission rate after craniotomy for tumor resection at safety net hospitals in small metropolitan areas.Journal of neuro-oncology · 2020Article
- Association Between Financial Incentives in Medicare's Hospital Readmissions Reduction Program and Hospital Readmission Performance.JAMA network open · 2020Article
- Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts.The Journal of bone and joint surgery. American volume · 2020Article
- Relative Effects of the Hospital Readmissions Reduction Program on Hospitals That Serve Poorer Patients.Medical care · 2019Article
- Public reporting on cardiac electrophysiology procedures and outcomes: where are we now and where are we headed?Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo compare trends in readmission rates among safety net and non-safety net hospitals under the US Hospital Readmission Reduction Program (HRRP).
designA retrospective time series analysis using Medicare administrative claims data from January 2008 to June 2015.
settingWe examined 3254 US hospitals eligible for penalties under the HRRP, categorised as safety net or non-safety net hospitals based on the hospital's proportion of patients with low socioeconomic status.
participantsAdmissions for Medicare fee-for-service patients, age ≥65 years, discharged alive, who had a valid five-digit zip code and did not have a principal discharge diagnosis of cancer or psychiatric illness were included, for a total of 52 516 213 index admissions. PRIMARY AND SECONDARY OUTCOME MEASURES: Mean hospital-level, all-condition, 30-day risk-adjusted standardised unplanned readmission rate, measured quarterly, along with quarterly rate of change, and an interrupted time series examining: April-June 2010, after HRRP was passed, and October-December 2012, after HRRP penalties were implemented.
results58.0% (SD 15.3) of safety net hospitals and 17.1% (SD 10.4) of non-safety net hospitals' patients were in the lowest quartile of socioeconomic status. The mean safety net hospital standardised readmission rate declined from 17.0% (SD 3.7) to 13.6% (SD 3.6), whereas the mean non-safety net hospital declined from 15.4% (SD 3.0) to 12.7% (SD 2.5). The absolute difference in rates between safety net and non-safety net hospitals declined from 1.6% (95% CI 1.3 to 1.9) to 0.9% (0.7 to 1.2). The quarterly decline in standardised readmission rates was 0.03 percentage points (95% CI 0.03 to 0.02, p<0.001) greater among safety net hospitals over the entire study period, and no differential change among safety net and non-safety net hospitals was found after either HRRP was passed or penalties enacted.
conclusionsSince HRRP was passed and penalties implemented, readmission rates for safety net hospitals have decreased more rapidly than those for non-safety net hospitals.
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