Accounting for the Growth of Observation Stays in the Assessment of Medicare's Hospital Readmissions Reduction Program¶
Sabbatini, A. K., Joynt-Maddox, K. E., Liao, J. M., Basu, A., Parrish, C., Kreuter, W., & Wright, B. (2022). Accounting for the Growth of Observation Stays in the Assessment of Medicare's Hospital Readmissions Reduction Program. JAMA Network Open, 5(11).
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- Construct Validity
- The same move applies one substrate over, in a hospital adopting a 30-day-readmission rate as a proxy for care quality: gaming (coding admissions as observation stays) erodes the bridge once the metric is made consequential
This sourceFully accounting for observation stays more than halved the apparent HRRP-era decrease in 30-day readmissions, and the program's association with lower readmissions disappeared — i.e., reclassifying inpatient admissions as observation stays (which are excluded from the readmission metric) once the metric became consequential hollowed out its validity as a proxy for care quality.
- The same move applies one substrate over, in a hospital adopting a 30-day-readmission rate as a proxy for care quality: gaming (coding admissions as observation stays) erodes the bridge once the metric is made consequential
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