Social factors impact hospitals' readmission penalty measures, study shows

A team of researchers led by a University of Colorado School of Medicine faculty member found that measures to evaluate readmission rates at children's hospitals would be more accurate if the social factors of the patients are included.

The study, "Adding Social Determinant Data Changes Children's Hospitals' Readmissions Performance," published online this month by the Journal of Pediatrics, shows that social factors that are outside the hospitals' control have an effect on the risk of readmission and should be included in any rating system that considers readmission rates as part of the hospitals' compensation.

"Our study shows that social determinants of health are important factors that can impact penalties that are levied for readmissions," said lead author Marion Sills, MD, MPH, professor of pediatrics at the University of Colorado School of Medicine. "As a result, evaluating hospital performance and setting pay-for-performance measures should include those factors."

Social determinants of health include such factors as race and ethnicity, public insurance and median household income.

"Our concern is that most readmission penalty measures do not include adjustment for social determinants of health despite evidence that these factors have a greater impact on overall health than the healthcare received," Sills said.

The team of researchers evaluated 458,686 discharges at 47 hospitals reporting data to the Pediatric Health Information database between January 2014 and December 2014. Their analysis was adjusted for factors that included information related to socio-economic data for households by ZIP Code. The team found that performance rankings changed for 77 percent of the hospitals when such factors were included in the analysis.

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