PHOENIX MEDICAL MANAGEMENT, INC.

Researchers on the hunt for clues to predict which hospital patients will return for a second stay have so far made only marginal progress.  Two recent studies have demonstrated that readmissions prevention strategies haven't worked as well as predicted.  In the Annals of Internal Medicine, a review of studies testing readmissions prevention strategies has found that there isn't any clear evidence that such strategies actually reduce readmission rates.  The researchers divided the strategies into 3 categories:  Pre-discharge, post-discharge, and bridging.  But none came out a winner.  Similarly, JAMA (Oct 19) had an article showing that risk models used to predict which patients are at high risk for readmissions have been mostly limited and not terribly effective. The authors of this study reviewed 30 studies of 26 unique risk-prediction models to test their performance.  Most studies considered whether the patients had multiple diseases and how often, if at all, they used medical care and nearly all the studies also used age and gender.  But other variables were frequently absent from the models such as measures of the patient's functional status, complexity of the patient's medication regimen, social support and access to care.

Until there is evidence of an evidence based method to identify patients at risk for readmissions and strategies that work, hospitals may be wasting resources by targeting the wrong patients and it may be premature to impose penalties on hospitals slated to begin in 2013.