Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

HRRP & Patient Mortality in HF, AMI & Pneumonia

JAMA; 2018 Dec 25; Wadhera, et al

Among a large cohort of Medicare beneficiaries, the Hospital Readmissions Reduction Program (HRRP) was significantly associated with an increased in 30-day postdischarge mortality after hospitalization for heart failure (HF) and pneumonia, but not for acute myocardial infarction (AMI). The retrospective cohort study included 8.3 million hospitalizations for HF, AMI, and pneumonia from 2005 to 2015. The primary outcomes included inverse probability-weighted mortality within 30 days of discharge following hospitalization for HF, AMI, and pneumonia, stratified by whether there was an associated readmission. Researchers found:

  • There were 270,517 deaths within 30 days of discharge for HF, 128,088 for AMI, and 246,154 for pneumonia.
  • There was a statistically significant association with implementation of the HRRP and increased post-discharge mortality for patients hospitalized for HF and pneumonia, but not AMI.
  • For all 3 conditions, HRRP implementation was not significantly associated with an increase in mortality within 45 days of admission, relative to pre-HRRP trends.


Wadhera RK, Joynt Maddox KE, Wasfy JH, Haneuse S, Shen C, Yeh RW. Association of the hospital readmissions reduction program with mortality among Medicare beneficiaries hospitalized for heart failure, acute myocardial infarction, and pneumonia. JAMA. 2018;320(24):2542–2552. doi:10.1001/jama.2018.19232.

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