Pitfalls of calculating hospital readmission rates based on nonvalidated administrative data sets

Abstract

Object Administrative databases are increasingly being used to establish benchmarks for quality of care and to compare performance across peer hospitals. As proposals for accountable care organizations are being developed, readmission rates will be increasingly scrutinized. The purpose of the present study was to assess whether the all-cause readmissions rate appropriately reflects the University of California, San Francisco (UCSF) Medical Center hospital's clinically relevant readmission rate for spine surgery patients and to identify predictors of readmission. Methods Data for 5780 consecutive patient encounters managed by 10 spine surgeons at UCSF Medical Center from October 2007 to June 2011 were abstracted from the University HealthSystem Consortium (UHC) using the Clinical Data Base/Resource Manager. Of these 5780 patient encounters, 281 patients (4.9%) were rehospitalized within 30 days of the previous discharge date. The authors performed an independent chart review to determine clinically relevan...