Recent Study Highlights Importance of Emergency Department in Readmissions

Emergency departments may play a surprising role in the reduction of readmission rates following the implementation of Medicare’s Hospital Readmissions Reduction Program, according to a recent analysis.

Charleen Hsuan, assistant professor of health policy and administration at Penn State, led a study that examined what happens to discharged patients when they returned to a hospital’s emergency department. The results were recently published in JAMA Network Open.

For their research, the authors used a retrospective analysis examining hospital data from three states: California, Florida and New York.

The researchers found the Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in the probability of readmission for recently discharged patients presenting to the emergency department, even for conditions for which admission is usually indicated, including congestive heart failure.

The analysis also showed that almost all patients with unplanned readmissions come through the emergency department.

Especially during times such as the COVID-19 pandemic, it is important to reduce the number of unnecessary patients in the hospital. “Medicare’s HRRP aims to do this by reducing unnecessary readmissions for patients hospitalized with key conditions,” said Hsuan. “Our study found that the emergency department is an important gatekeeper for readmission decisions.”

The study was supported by the National Center for Advancing Translation Sciences of the National Institutes of Health (NIH), through Penn State Clinical and Translational Science Institute and the Population Research Institute at Penn State.

In addition to Hsuan, other authors of the paper include Brendan Carr, Icahn School of Medicine at Mount Sinai; Renee Y. Hsia, University of California, San Francisco; and Geoffrey J. Hoffman, University of Michigan School of Nursing, Ann Arbor.