Hospital Readmission Reduction Program May Unfairly Penalize Hospitals

The Hospital Readmission Reduction Program (HRRP) may unfairly penalize hospitals if 30-day readmission rates are the only metric for care quality among patients who undergo surgery for ovarian cancer, according to a study presented at the 48^th Annual Meeting of the Society of Gynecologic Oncology.¹

Oncologic procedures are associated with higher initial morbidity that may lead to higher readmission rates; surgical quality is therefore not defined only by the otherwise-standard 30-day outcomes. For this study, researchers evaluated hospital readmission rate as a quality measure in ovarian cancer surgery.

Investigators analyzed data from 36,674 patients diagnosed with stage III or IV serous ovarian carcinoma undergoing primary debulking surgery between 2004 and 2012 who were included in the National Cancer Data Base.

After adjusting for patient, tumor, and treatment factors, investigators found that hospitals with 31 cases per year or more had the highest readmission rates, while possessing significantly lower 90-day mortality rates, higher adherence to National Comprehensive Cancer Network (NCCN) guidelines, and higher 5-year overall survival rates compared with hospitals that performed fewer than 31 surgeries for ovarian cancer annually.

The findings suggest that if HRRP was to encourage reducing readmission rates among patients who undergo surgery for ovarian cancer, hospitals may be unfairly penalized if survival metrics are not used to measure surgical quality.

Reference

1. Uppal S, Spencer R, del Carmen MG, Rice LW, Griggs J. Hospital readmission as a quality measure in ovarian cancer surgery. Paper presented at: 48^th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.