Risk-adjusted 30-day home time among patients discharged after a hospitalization for heart failure (HF) is an applicable hospital-level quality patient-centered performance metric and incorporates 30-day readmission, 30-day mortality, and 1-year mortality outcomes (JAMA Cardiol. 2020;e204928. doi:10.1001/jamacardio.2020.4928).
This hospital-level cohort study aimed “to characterize risk-adjusted 30-day home time in patients discharged with HF as a hospital-level quality metric and evaluate its association with the 30-day risk-standardized readmission rate (RSRR), 30-day risk-standardized mortality rate (RSMR), and 1-year RSMR,” according to Ambarish Pandey, MD, MSCS, Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center (Dallas, TX) and colleagues.
The study retrospectively analyzed 100% of Medicare claims data from 2,968,341 patients from 3134 facilities from January 1, 2012, to November 30, 2017. A risk-adjusted 30-day home time for HF was calculated and correlated between hospital rates of risk-adjusted 30-day RSRR, 30-day RSMR, and 1-year RSMR.
Across increasing 30-day home time categories, 30-day readmission, 30-day mortality, and 1-year mortality rates decreased in a graded fashion. Thirty-day home time reclassified hospital performance in 30% of the hospitals.
“In this study, 30-day home time among patients discharged after a hospitalization for HF was objectively assessed as a hospital-level quality metric using Medicare claims data and was associated with readmission and mortality outcomes and with reclassification of hospital performance compared with 30-day RSRR and 30-day RSMR,” concluded Dr Pandey and colleagues.—Lisa Kuhns
