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Lagoe, R.J., et. al. (13 Aug 1999) "Analyzing hospital readmissions using statewide discharge databases." Nursing Care Quarterly 13(6): 57-67.
Why did the authors select hospital readmissions as a way to evaluate the quality of care for these DRGs?
In contrast to simply measuring the patient's lengths of stay, the swiftness or slowness of patient discharge rates, lengths of patient occupancy, or patient mortality, measuring hospital readmissions rates were through to be an effective means of evaluating quality of care. The readmissions rate specifically measures treatment efficiency, namely that readmission often occurs when a condition that was not likely to have been treated during the patient's first stay of occupancy. In other words, length of stay by definition is affected by the patient's severity of illness -- the fact that a hospital might treat more children with broken legs (necessitating overnight stay) than chicken pox (not necessitating overnight stay) is not a determinative factor of quality of care.
Valuing discharge rates might mean a hospital that repeatedly kept patients too long for minor complaints, or discharged patients with serious complaints might receive praise, depending on the valuation method of length of swiftness. Occupancy might mean a patient was moved to another hospital,...
Lastly, some ailments have a higher mortality rate than others, regardless of the quality of care that the patients received.
The goal of the study was to find some factor with extensive and wide-ranging data, that was available on individual hospital and community databases, but which would not be biased against a hospital if, for example it had a larger amount of cardiac or critical care patients in its treatment units or if a particular community had a large amount of patients requiring long-term stays and care. But patients who are repeatedly discharged and must return are often not being treated effectively, that is clear, regardless of the severity of their aliment and the length of their stay. (58) The purpose of the study was also to encourage helpful sharing of data about patients in the most inexpensive and efficient fashions possible, as determined by the structure of comparing data over the course of the study, through the use of less expensive and smaller frameworks of recorded data. (66)
In terms of methodology in data analysis, patients with illnesses requiring readmission and examination could be flagged in the database such as stroke patients. For the study, urban areas were usually selected because they…
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