Not All Readmissions Are Created Equal

In a retrospective review by Hannan et al. (1) in this issue of JACC Cardiovascular Interventions, 30-day readmission rates for percutaneous coronary intervention (PCI) patients were analyzed using both clinical and administrative datasets to determine overall readmission rates, planned or staged readmissions, and a determination of predictors for unstaged readmissions. The 30-day readmission rates categorized using administrative data in this study underscore the diverse sources of readmission data and the challenges involved in their evaluation. Readmissions are an important area of interest as they are a major cost item and, because they are considered a failure of the initial care, are often used as a surrogate of quality (2). Healthcare reform proposals from the federal government include payment withholdings for high readmission rates. The Center for Medicare Services' proposed Hospital Value-Based Purchasing Program includes penalties on the Inpatient Prospective Payment System for high rates of preventable readmissions.