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UIHC heart-attack readmission rate above average

BY ALINA RUBEZHOVA | JULY 16, 2009 7:15 AM

Newly released readmission rates for hospitals are another way for patients to compare facilities.

The UI Hospitals and Clinics scored worse than the national average in one of three comparable areas — meaning its readmission rate was above the national average, according to the Centers for Medicare and Medicaid Services’ Hospital Compare website. Now, officials said, they will use these statistics to determine what factors result in readmission, and what could be done to prevent it.

“[It provides] us with valuable information that helps us continue to ensure that we are providing the highest possible level of quality in our patient care,” said UI spokesman Tom Moore.

The Centers for Medicare and Medicaid Services began to look into the issue after a national push by the Obama administration. The president’s health-care reform identified readmission rates as a key target for medical-care savings.

The Hospital Compare site allows patients to compare hospitals based on the how the rate of readmission for three treatments — heart attack, heart failure, and pneumonia — compare with the national average.

Over a 30-day period, the UIHC had 23.5 percent readmission of heart attack patients. This is roughly 3 percentage points above the national rate of 19.9 percent, according to the U.S. Department of Health and Human Services.

Out of 109 hospitals in Iowa, only the UIHC exceeded the national average, one hospital had a lower rate, and 29 were on par with the average. In Iowa, 78 hospitals could not collect enough data to determine performance in this area.

In other treatments — heart failure and pneumonia readmission — the UIHC was equal to the national average.

While a significant step, these statistics can’t stand on their own.

Tony Salters, a Center for Medicare and Medicaid Services spokesman said many patients may not be readmitted for the same condition. Rather, return visits may relate to follow-up procedures and diagnoses for additional disorders.

Moore said many of the patients who come into the UIHC are severely ill and often suffer “comorbidities” — unrelated diseases that are usually used to indicate the coexistence of two or more disease processes, according to the Iowa Association of Cardiopulmonary Rehabilitation. These include diabetes, high blood pressure, or high cholesterol.

“There are some readmissions that are avoidable, some that are not, and some that you just can’t plan for,” Salters said.

The new criteria give patients a broader idea of how a certain hospital is improving and treating the three problems. Hospitals should “better educate patients during and after that initial condition,” said Salters, meaning doctors must tell patients what secondary disorders could follow their initial diagnosis.

The majority of admissions to the UIHC come from within a 90-mile radius of the hospital, and the Medicare patients admitted are usually twice as sick as the national average, Moore said.

“[They’re] brought here because we’re recognized for our high level of expertise in caring for these severely ill patients,” he said.

Prior to the readmission criteria, patients primarily relied on a hospital’s mortality rate within a one-year period for heart attacks, heart failures and pneumonia.

Now they can view three full years of claim data.

“[This] gives people a better outlook at how hospitals have performed before a larger period of time,” said Salters, adding it levels the “playing field” of how long a hospital has had to correct or improve their statistics.

According to the Centers for Medicare and Medicaid Services press release, consumers are urged to not just look at only one process in evaluating hospitals.


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