Hospital readmission rates: signal of failure or success?
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Working Paper
Published version
Author(s)
Laudicella, M
Li Donni, P
Smith, PC
Type
Journal Article
Abstract
Hospital readmission rates are increasingly used as signals of hospital performance and a basis for hospital reimbursement. However, their interpretation may be complicated by differential patient survival rates. If patient characteristics are not perfectly observable and hospitals differ in their mortality rates, then hospitals with low mortality rates are likely to have a larger share of un-observably sicker patients at risk of a readmission. Their performance on readmissions will then be underestimated. We examine hospitals’ performance relaxing the assumption of independence between mortality and readmissions implicitly adopted in many empirical applications. We use data from the Hospital Episode Statistics on emergency admissions for fractured hip in 290,000 patients aged 65 and over from 2003 to 2008 in England. We find evidence of sample selection bias that affects inference from traditional models. We use a bivariate sample selection model to allow for the selection process and the dichotomous nature of the outcome variables.
Date Issued
2013-06-28
Date Acceptance
2013-06-11
Citation
Journal of Health Economics, 2013, 32 (5), pp.909-921
ISSN
0167-6296
Publisher
Elsevier
Start Page
909
End Page
921
Journal / Book Title
Journal of Health Economics
Volume
32
Issue
5
Copyright Statement
© 2013 The Authors. Published by Elsevier B.V. Open access under CC BY license
License URL
Subjects
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Economics
Health Care Sciences & Services
Health Policy & Services
Business & Economics
ECONOMICS
HEALTH CARE SCIENCES & SERVICES
HEALTH POLICY & SERVICES
Hospital performance
Mortality rates
Readmission rates
Sample selection
Hip fractures
ACUTE MYOCARDIAL-INFARCTION
SAMPLE SELECTION
MORTALITY-RATES
HIP FRACTURE
OUTCOMES
QUALITY
HEALTH
IMPACT
COSTS
MODEL
C50
I18
Aged
Aged, 80 and over
England
Female
Hip Fractures
Hospitals
Humans
Male
Models, Statistical
Patient Readmission
Quality of Health Care
Survival Rate
1402 Applied Economics
1117 Public Health And Health Services
Publication Status
Published