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CareSet Pathway: 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