Community Factors and Hospital Readmission Rates
Version of Record online: 9 APR 2014
© Health Research and Educational Trust
Health Services Research
Volume 50, Issue 1, pages 20–39, February 2015
How to Cite
Herrin, J., St. Andre, J., Kenward, K., Joshi, M. S., Audet, A.-M. J. and Hines, S. C. (2015), Community Factors and Hospital Readmission Rates. Health Services Research, 50: 20–39. doi: 10.1111/1475-6773.12177
- Issue online: 29 JAN 2015
- Version of Record online: 9 APR 2014
- The Commonwealth Fund
- socioeconomic status
To examine the relationship between community factors and hospital readmission rates.
Data Sources/Study Setting
We examined all hospitals with publicly reported 30-day readmission rates for patients discharged during July 1, 2007, to June 30, 2010, with acute myocardial infarction (AMI), heart failure (HF), or pneumonia (PN). We linked these to publicly available county data from the Area Resource File, the Census, Nursing Home Compare, and the Neilsen PopFacts datasets.
We used hierarchical linear models to assess the effect of county demographic, access to care, and nursing home quality characteristics on the pooled 30-day risk-standardized readmission rate.
Data Collection/Extraction Methods
The study sample included 4,073 hospitals. Fifty-eight percent of national variation in hospital readmission rates was explained by the county in which the hospital was located. In multivariable analysis, a number of county characteristics were found to be independently associated with higher readmission rates, the strongest associations being for measures of access to care. These county characteristics explained almost half of the total variation across counties.
Community factors, as measured by county characteristics, explain a substantial amount of variation in hospital readmission rates.