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Supply and demand have more to do with readmission rates over illness severity and care quality, according to new research presented at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions. Differences in regional hospitals for heart failure, in fact, have more to do with the number of hospital beds (availability of care) and income levels (socioeconomics), rather than hospital performance, the American Heart Association said Friday.

Heart failure–one of the three conditions that the Centers for Medicare & Medicaid Services will ding high-readmission hospitals for with reduced Medicare payments in October–has wide variations across the country. Heart failure readmissions range from 10 percent to 32 percent. The new research found that areas with higher rates were likely to have more physicians and hospital beds, and their populations were likely to be poor, black and relatively sicker.

Supply factors like the availability of doctors and beds accounted for 17 percent of the variation in readmission rates, and poverty and minority makeup accounted for 9 percent. Hospital quality performance, on the other hand, only accounted for 5 percent, and degree of illness accounted for 4 percent.

With readmission rates linked to reimbursement, the study suggests that Medicare penalties may be ineffective at improving care, according to the research announcement.

“We need to think less about comparing hospitals to each other in terms of their performance and more about looking at improvement in hospitals and communities,” lead study author Karen E. Joynt, an instructor at Brigham and Women’s Hospital, Harvard Medical School and the Harvard School of Public Health in Boston, said in the announcement. Joynt stressed thinking about readmissions in terms of community and population health.

The American Hospital Association also expressed concerns in its advocacy papers this month regarding low-income areas and the forthcoming Medicare penalties. “There is compelling evidence that safety-net hospitals and others serving large numbers of low-income individuals will have difficulty reducing readmissions due to the lack of some of these resources in the communities they serve. This creates an unfair system that puts these hospitals at greater risk for substantial readmission penalties.”

Read more: Readmissions linked to beds, income more than quality – FierceHealthcare http://www.fiercehealthcare.com/story/readmissions-linked-beds-income-more-quality/2012-05-14#ixzz1uwo6xQat

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