To examine patterns and determinants of nonindex readmissions
as well as non-Medicare
patients both before and immediately after the adoption of Medicare
's Hospital Readmission Reduction Program (HRRP) in 2012. Nonindex readmissions
to hospitals that are different from the one from which the patient was discharged.
Observational analysis of statewide database from California comprising patient-level discharge reports. Mixed-effects logistic regression models examined the association between nonindex readmissions
and both hospital- and patient-level characteristics.
for the population studied were approximately 25%, but the percentage of such readmissions
was significantly higher for non-Medicare
patients than those enrolled in Medicare
. Nonindex readmissions
were associated with several patient- and hospital-level characteristics from which patients were discharged. The adoption of the HRRP did not have any appreciable impact on the general pattern of nonindex readmissions
A substantial percentage of hospital readmissions
are to nonindex hospitals, but the general pattern and determinants of these events have not changed following the adoption of the HRRP. As preventable readmissions
continue to gain attention as a key quality indicator for hospital care, further investigations are needed to understand the potential value of nonindex readmissions
as a quality indicator for hospital care.