PATH ALONG Attributes Of Review Impact Rural Readmission Rates

When examining data it is valuable to identify design ascribed to recorded information as a measure of quality.  The measure assigned to features of the study can shift the translation as relates to the degree of quality inherent in the result.  Simply alter the features of the study design and you may receive a variation, unstable result.

The attributes of review related to the study of hospital readmission rates include:

1. The length of the post discharge time period examined.

2. Which diagnosis are included.

3. Include only those readmissions deemed potentially preventable or calculate all.

4. Carve out readmissions for Medicare patients or list all.

The attributes selected make a difference when the hospital serves a less densely populated rural area.  Depending on the volume of admissions the diagnosis specific readmission rates may not provide an accurate measure of the quality of care.  Low volume of admissions of a condition specific rate may generate a less than accurate value.

The helecopter flies out not in.  Many rural hospitals have policy in place that results in critical care patients being emergently transported to a larger hospital.  The larger hospital employs staff who are more comfortable with delivering the treatments needed to stabilize the patient.  Advanced equipment is available.  How does the study include the patients who are transferred from a smaller community hospital  during their initial episode of illness.

Observation seems to indicate rural hospitals admit a significantly higher proportion of Medicare beneficiares making them more reliant on Medicare payments.  Losing a percentage of needed Medicare revenue may have a larger impact on the fragile budget of a smaller rural community hospital.

PATH ALONG is by design an operational model capable of serving hospitals who deliver care in the rural setting.  PATH ALONG is an original Wisconsin model that connects inpatient providers to community staff who support the patient during health system transitions. 

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