Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018.

Ryo Onishi,Yosuke Hatakeyama,Kunichika Matsumoto,Tomonori Hasegawa,Kanako Seto,Koki Hirata

doi:10.3390/ijerph18147624

Ryo Onishi, Yosuke Hatakeyama + Show 4 more

Open Access

https://doi.org/10.3390/ijerph18147624

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Abstract

Previous studies indicated that optimal care for pneumonia during hospitalization might reduce the risk of in-hospital mortality and subsequent readmission. This study was a retrospective observational study using Japanese administrative claims data from April 2010 to March 2019. We analyzed data from 167,120 inpatients with pneumonia ≥15 years old in the benchmarking project managed by All Japan Hospital Association. Hospital-level risk-adjusted ratios of 30-day readmission for pneumonia were calculated using multivariable logistic regression analyses. The Spearman’s correlation coefficient was used to assess the correlation in each consecutive period. In the analysis using complete 9-year data including 54,756 inpatients, the hospital standardized readmission ratios (HSRRs) showed wide variation among hospitals and improvement trend (r = −0.18, p = 0.03). In the analyses of trends in each consecutive period, the HSRRS were positively correlated between ‘2010–2012’ and ‘2013–2015’ (r = 0.255, p = 0.010), and ‘2013–2015’ and ‘2016–2018’ (r = 0.603, p < 0.001). This study denoted the HSRRs for pneumonia could be calculated using Japanese administrative claims data. The HSRRs significantly varied among hospitals with comparable case-mix, and could relatively evaluate the quality of preventing readmission including long-term trends. The HSRRs can be used as yet another measure to help improve quality of care over time if other indicators are examined in parallel.

Highlights

Pneumonia is one of the leading causes of morbidity, hospitalization, and mortality associated with infectious diseases worldwide and affects all age groups, especially elderly people
Previous studies indicated that optimal care for pneumonia during hospitalization might reduce the risk of in-hospital mortality and subsequent readmission which was considered an indicator of inadequate hospital care [5,6]
This study aimed to reveal the trends of the hospital standardized readmission ratios (HSRRs) for pneumonia in Japan

Summary

Introduction

Pneumonia is one of the leading causes of morbidity, hospitalization, and mortality associated with infectious diseases worldwide and affects all age groups, especially elderly people. Many developed countries, such as Japan, are dealing with a super-aged society, wherein multi-morbidity is a common scenario. In the past few decades, many efforts have been made to improve the quality of in-hospital care for pneumonia. The hospital standardized mortality ratio (HSMR) is an indicator for assessing the in-hospital mortality ratio based on the case-mix adjustment with patient risk factors, and identifying areas that can be changed to improve patient safety and the quality of care.

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