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

readmission graph

Ashish Patel

Ashish is co-founder of CareSet Systems. An entrepreneur and healthcare data transparency advocate, Ashish also founded the DocGraph Journal, bringing together the Healthcare Data Science community along with Politico and ProPublica to publish data sets for scientific advancement. Ashish is currently working to decode Medicare Claims data for Pharmaceutical companies, helping analyze provider teaming, and building robust networks.