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JAMA Viewpoint Argue Against Readmission Rates as Best Measure of Hospital Quality

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In 2010, reducing hospital readmissions appeared to be a fruitful target for quality improvement. However, in a Viewpoint published in JAMA, a group of doctors argue that the persistent focus on readmissions during the past decade, although undoubtedly leading to some improvements in care, has had minimal demonstrable benefit. In 2022, after more than a decade of concerted effort, they conclude it is time to focus limited hospital resources on more tractable and evidence-based targets that are more directly under the control of hospitals.

The authors write that the Hospital Readmissions Reduction Program (HRRP) has distracted clinicians and health system leaders from other crucial quality concerns. As with many other quality measures, the HRRP has led to gamesmanship whereby hospitals have taken predictable actions in their coding practices and admission processes and protocols in an effort to minimize the probability of receiving penalties. The authors argue that it is time to refocus hospital quality improvement efforts where they can be most effective and beneficial, which means deemphasizing the HRRP.

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