CareSet Journey: Readmission Case Study
Cross-facility Re-admissions Analysis
Background: Nearly all hospitals have difficulty tracking readmissions to neighboring hospitals due to lack of data sharing.
Using CareSet’s longitudinal access to 100% Part A, we conducted analysis quantifying the number of cancer-related discharges that readmit for emergency or urgent care at non-discharging facilities.
This work was limited to selected PPS‐exempt hospitals (PeH).
Denominator: # of impacted Patients Discharged from PeHs
Index admissions with all of the following:
1.Medicare patients
2.Adults (18+ years)
3.Diagnosis – ICD-9-CM range: [redacted] ICD-10-CM range: [redacted]
4.Inpatient discharges from PeH in CY2013-CY2015
Denominator: Excluded
1.Incomplete or missing data – Discharge code 0
2.In-hospital death – Discharge code 20
3.Transferred to another acute care facility – Discharge codes 02, 05, 09, 30, 66, 69, 81-95
4.Admission to an inpatient hospice bed – Discharge codes 40, 41, 42
5.Discharged against medical advice (AMA) – Discharge code 07
Numerator Inclusions – Denominator index admissions with any:
1.Principal diagnosis of disease – ICD-9-CM range: [redacted]; ICD- 10-CM range: [redacted]
2.Principal diagnosis requiring therapy – ICD-9- CM range: [redacted]; ICD-10-CM range: [redacted]
Numerator Exclusions – Denominator index admissions with all:
1.Readmission to any acute care facility within 30 days of the discharge date for the index admission
2.“Emergency” or “Urgent” admission status – Admit codes 1, 2
Readmission Results From 2013-2015
30‐Day unplanned readmissions for patients across a leading group of Specialist Hospitals