Momotazur Rahman Ph.D., John McHugh Ph.D., Pedro L. Gozalo Ph.D., Dana Clay Ackerly M.D., Vincent Mor Ph.D.
To examine the relative influence of hospital and skilled nursing facilities (s) on 30‐day rehospitalization.
Elderly Medicare beneficiaries newly admitted to a following hospitalization.
We ranked hospitals and s into quartiles based on previous years’ adjusted rehospitalization rates (s) and examined how rehospitalizations from a given hospital vary depending upon the admitting quartile. We examined whether the availability of s with low rehospitalization rates influenced hospitals’ readmission rates and whether changes in a hospital's over 3 years is associated with changes in the s to which they discharge.
Hospital readmission rates from s varied 5 percentage points between patients discharged to s in the lowest and the highest rehospitalization quartiles. Low rehospitalization rate hospitals sent a larger fraction of their patients to the lowest rehospitalization s available in the area. A 10 percent increase in hospital's share of discharges to the lowest rehospitalization quartile s is associated with a 1 percentage point reduction in hospital's .
The rehospitalization rate has greater influence on patients’ risk of rehospitalization than the discharging hospital. Identifying high‐performing s may be a powerful strategy for hospitals to reduce rehospitalizations.