Guide to Revised Readmission Reports
General
All readmissions are based on 15 days
Based on AHCA patient discharge data for October 1, 2008, through September 30, 2009
Conditions are defined based on the APR-DRG
Data is for ALL patients
Report 1: Which patients are being readmitted
This report is designed to look at which patients are being readmitted and the payer (Medicare (includes Medicare Advantage), Medicaid (includes Medicaid HMO), Commercial (HMO, PPO and other private pay), Self Pay/Uninsured (which includes charity) and Other (workers compensation, CHAMPUS, other government, VA).
# of patients admitted with that condition
# of patients readmitted within 15 days
Same - # of patients readmitted to the hospital that the patient was initially seen
Other - # of patients readmitted to a different hospital from the one that the patient was originally treated
% readmitted to another hospital
15 day readmission rate
Patients readmitted once – # of patients readmitted only once during the 15 day period
Patients readmitted twice - # of patients readmitted twice during the 15 day period
Patients readmitted more than three times - # of patients readmitted three or more times during the 15 day period
Readmission rate by location to which the patient was originally discharged – this looks at the discharge status from the original admission to analyze the readmissions back to any hospital. Data is analyzed for:
Skilled Nursing Facilities (SNF)
Home health/home infusion
Home
Other (includes rehabilitation, intermediate care, hospice, left AMA but not transferred to another hospital since those are excluded)
# of patients - # of patients discharged to SNF/Home health/Home/Other with that condition
# of patients readmitted - # of patients discharged to SNF/Home health/Home/Other with that condition that were readmitted within 15 days
Readmission rate - % of patients readmitted that were originally discharged to those settings
Report 2: Reasons for Readmission
This report looks that the principal diagnosis code for the readmission, showing the five most common principal diagnosis codes for the readmission. The columns are the same as above except for the readmissions by location to which the patient was originally discharged.
For SNF, Home health/Home Infusion, Home and Other
# of patients readmitted for that principal diagnosis code
% of readmits for CHF – this is the % of the total readmissions for that condition that were readmitted with that principal procedure code.
Report 3: Financial Impact
This report shows the charges associated with the readmission by payer. Please note that the charges would include those charges readmitted to the original hospital and charges for patients readmitted to another hospital.