30-day unplanned readmission and death measures
The readmission measures are estimates of unplanned readmission to an acute care hospital in the 30 days after discharge from a hospitalization. Patients may have had an unplanned readmission for any reason.
For a full list of readmission measures, click here.
The death (mortality) measures are estimates of deaths in the 30 days after either:
- Entering the hospital for a specific condition; or
- Having a coronary artery bypass graft (CABG) surgery.
Deaths can be for any reason, and can occur in the hospital or after discharge.
For a full list of mortality measures, click here.
Readmission and death rates are measured within 30 days, because readmissions and deaths after a longer time period may have less to do with the care gotten in the hospital and more to do with other complicating illnesses, patients’ own behavior, or care provided to patients after hospital discharge.expand
Which patients are included
The readmission and death measures include hospitalizations for Medicare beneficiaries 65 or older who were enrolled in Original Medicare for 12 months before their hospital admission (and for readmissions, for 30 days after their original admission). The readmission measures do not include patients who died during the index admission, or who left the hospital against medical advice.
Where the information comes from
Medicare calculates hospital-specific readmission and death rates using Medicare claims data and eligibility data. Using claims and eligibility data makes it possible to calculate readmission and death rates without having to review medical charts or requiring hospitals to report additional information. Medicare conducted research during the development of the initial readmission and death measures, which showed that measures that use claims data performed well compared to measures that use information from medical charts when estimating hospital readmission and death rates.
To accurately compare hospital performance, the readmission and death measures adjust for patient characteristics that may make readmission or death more likely. These characteristics include the patient’s age, past medical history, and other diseases or conditions (comorbidities) the patient had when they were admitted that are known to increase the patient’s chance of dying or of having a readmission.
The statistical model, used to calculate readmission and death measures, confirms the estimated rates are precise, and provides the interval estimates for each hospital’s rates. The upper and lower boundaries of an interval estimate represents a range, in which there is 95% certainty the true rate lies.
Hospital Performance Categories
The hospital’s interval estimate is compared to the national readmission rate or death rate. For each measure the hospital’s performance is categorized as:
- "Better than the National Rate" if the entire 95% interval estimate surrounding the hospital’s rate is lower than the national rate;
- "No different than the National Rate" if the 95% interval estimate surrounding the hospital’s rate includes the national rate; or
- "Worse than the National Rate" if the entire 95% interval estimate surrounding the hospital’s rate is higher than the national rate.
- "The number of cases is too small (fewer than 25) to reliably tell how well the hospital is performing" if a hospital has fewer than 25 eligible cases.
For more detail on how the 30-day unplanned readmission rates are calculated, please refer to QualityNet - Readmission Measures- Opens in a new window Exit Disclaimer - Opens in a new window. For other questions regarding the 30-day unplanned readmission measures, please email firstname.lastname@example.org.Exit Disclaimer - Opens in a new window
For more detail on how the 30-day death (mortality) rates are calculated, please refer to QualityNet - Mortality Measures- Opens in a new windowExit Disclaimer - Opens in a new window. For other questions regarding the 30-day death (mortality) measures, please email email@example.com.Exit Disclaimer - Opens in a new window