Clinical Edge

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

Hospital Readmissions Following HF Hospitalization

JAMA Cardiol; ePub 2017 Nov 12; Gupta, et al

Implementation of the Hospital Readmissions Reduction Program (HRRP) among fee-for-service Medicare beneficiaries discharged after heart failure (HF) hospitalizations was temporarily associated with a reduction in 30-day and 1-year readmissions, but an increase in 30-day and 1-year mortality. This according to an observational study of 115,245 fee-for-service Medicare beneficiaries (mean age 80.5 years, 54.6% women, 81.3% white, 9.7% black) that examined risk-adjusted 30-day and 1-year all-cause readmission and mortality rates. Researchers found:

  • 30-day risk-adjusted readmission rate declined from 20.0% before the HRRP implementation to 18.4% in the HRRP penalties phase (HR after vs before implementation, 0.91).
  • Conversely, the 30-day risk-adjusted mortality rate increased from 7.2% before the HRRP implementation to 8.6% in the HRRP penalties phase (HR after vs before implementation, 1.18).
  • The 1-year risk-adjusted readmission and mortality rates followed a similar pattern as the 30-day outcomes.


Gupta A, Allen LA, Bhatt DL, et al. Association of the Hospital Readmissions Reduction Program Implementation with readmission and mortality outcomes in heart failure. [Published online ahead of print November 12, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.4265.

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