Calculation of 30-Day Risk-Standardized Mortality Rates and Rates of Readmission









The 30-day risk-standardized mortality and 30-day risk-standardized readmission measures for heart attack, heart failure, and pneumonia are produced from Medicare claims and enrollment data using sophisticated statistical modeling techniques that adjust for patient-level risk factors and account for the clustering of patients within hospitals.


Mortality Measures

The three mortality models estimate hospital-specific, risk-standardized, all-cause 30-day mortality rates for patients hospitalized with a principal diagnosis of heart attack, heart failure, and pneumonia. All-cause mortality is defined as death from any cause within 30 days after the add link here index admission- Opens in a new window date, regardless of whether the patient dies while still in the hospital or after discharge. For each condition, the risk-standardized ("adjusted" or "risk-adjusted") hospital mortality rate can be used to compare performance across hospitals. The mortality measures for heart attack, heart failure, and pneumonia have been endorsed by the National Quality Forum (NQF), the non-profit public-private partnership organization that endorses national healthcare performance measures.


For more detail on how the 30-day mortality rates are calculated, please visit the Statistical Methods Used to Calculate Mortality Rates section.- Opens in a new window


Readmission Measures

The three readmission models estimate hospital-specific, risk-standardized, all-cause 30-day readmission rates for patients discharged alive to a non-acute care setting with a principal diagnosis of heart attack, heart failure, and pneumonia. For each condition, the risk-standardized ("adjusted" or "risk-adjusted") hospital readmission rate can be used to compare performance across hospitals. The readmission measures for heart attack, heart failure, and pneumonia have been endorsed by the National Quality Forum (NQF).


Because of the way hospitals are paid under Medicare in Maryland, readmissions to hospital-owned rehabilitation and psychiatric facilities were counted as readmissions to acute care hospitals. This adversely impacted the 30-day readmission rates for some Maryland hospitals. CMS suppressed the readmission measures results for Maryland Hospitals in June 2009 due to these coding issues unique to Maryland.


CMS has resolved this coding issue to accurately reflect readmissions in Maryland for the June 2010 (and beyond) updates of the readmission data for Maryland hospitals and will no longer suppress readmission measures results for Maryland Hospitals.


For more detail on how the 30-day readmission rates are calculated, please visit the Statistical Methods Used to Calculate Readmission Rates section.- Opens in a new window




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