3M algorithm overestimates preventable pediatric readmissions
Major finding: At 7, 15, and 30 days, PPR algorithm readmission rates were 2.5%, 4.1%, and 6.3% versus all-cause readmission rates of 5%, 8.7%, and 13.3%, respectively.
Data source: Retrospective analysis of 1.7 million admissions among 1.4 million pediatric patients.
Disclosures: Dr. Gay reported serving as the medical consultant to the Children’s Hospital Association.
AT PEDIATRIC HOSPITAL MEDICINE 2013
In a statement responding to Dr. Gay’s analysis, 3M Health Information Systems’ senior vice president of clinical and economic research, Richard Averill, said, "In payment applications, the number of PPRs for each provider is compared on a risk-adjusted basis to identify those providers with an ‘excess’ number of readmissions that are potentially preventable. Any payment adjustment for readmission is based only on the extent of excess readmissions.
"If all providers had the same PPR rate, no provider would have any excess PPRs and there would be no payment adjustment for readmission. Unfortunately, Dr. Gay’s comments omit any mention of how PPRs are actually being used and that they are not intended to provide a direct measure of the number of preventable readmissions."
Mr. Averill noted that Dr. Gay’s analysis observes that "half of readmissions detected by an ‘all-cause’ method would not be considered potentially preventable using PPRs. An examination of excess PPR rates across children’s hospitals can be an important quality improvement tool," he said.
In a separate interview, Dr. Shawn Ralston, chief of the pediatrics section, Dartmouth-Hitchcock Medical Center, Lebanon, N.H., agreed with Dr. Gay and said there are more pressing issues in pediatric clinical quality that deserve attention.
"I want meaningful quality measures developed by people with pediatric expertise and not things extrapolated from adult patients," Dr. Ralston added.
Dr. Gay reported serving as the medical consultant to the Children’s Hospital Association.
