URSA-PHF | Hospital Inpatient Readmission Metrics

Overview

This report contains measures and pre-built boards for assessing hospital inpatient readmissions. In addition to providing an introduction to industry standard configurations of a 30-day all cause readmission measure this report also provides variants of that measure and some intermediate process analytics on timely follow up which are commonly used to reduce readmissions.

Use this report to

• Refresh your understanding of industry standard conventions in the measure configuration for 30-day all cause readmissions.
• Analyze readmission rates across types of admissions and different patient populations.
• Identify the driving factors for readmissions and whether or not the readmissions is related to the index admission.
• Monitor performance over time across providers for timely follow up primary care visits following hospital inpatient admissions.

Potential takeaways

• What is my 30 day readmission rates across types of admissions (medical/surgical/behavioral/maternity)?
• What are the drivers of readmissions and could additional post-acute services (such as home health) prevented the readmission?
• What percent of readmissions are directly related to the index admission versus unrelated?
• How do readmission rates change when we look beyond 30 days (applicable for full risk groups)?
• Which facilities should we partner with more closely to facilitate better transitions of care?
• Which PCPs are our top/worst performers for timely follow up following an admission?
• Where is there variation across my providers, practices, chronic condition cohorts, and SDoH cohorts that may indicate a need for additional resources?

Measures included in this report

• URSA-PHF-R01: Patients with Active Membership
• URSA-PHF-R04: Registry of Hospital Inpatient Encounters
• URSA-PHF-030: 30-Day All-Cause Readmissions
• URSA-PHF-030b: 7-Day All-Cause Readmissions
• URSA-PHF-030c: 90-Day All-Cause Readmissions
• URSA-PHF-031: Subsequent Hospital IP Admits within 1 Year
• URSA-PHF-036: Post-Inpatient Primary Care Visit within 7 Days
• URSA-PHF-036b: Post-Inpatient Office Visit within 7 Days