Third, the researchers found that erroneous physician decision making and premature discharge were leading causes of early readmissions.
"Taken together, these findings suggest that readmissions in the week after discharge are more preventable and more likely to be caused by factors over which the hospital has direct control than those later in the 30-day window," the researchers wrote.
Beyond narrowing HRRP's 30-day readmissions window to seven days, the researchers also offer five recommendations to promote readmissions prevention:
- Hospitals should try to decrease cognitive errors that impact diagnosis and treatment
- The impact of hospital efforts to increase throughput on premature discharge should be examined
- Outpatient facilities should boost multidisciplinary care management for post-discharge monitoring of patients after discharge
- Access to primary care clinicians should be expanded
- Accountability for readmissions 30 days after discharge should be shared between outpatient and inpatient facilities
"Shared accountability over the 30 days, possibly with weighted penalties by readmission timing, would engage outpatient practices in readmission reduction efforts and reduce unfair financial penalties on hospitals."
Christopher Cheney is the senior clinical care editor at HealthLeaders.