Adhering to hospital guidelines may not reduce readmissions

Study finds wide variation in guideline adherence based on conditions

Procedural guidelines created to ensure quality hospital care do not have a significant impact on readmission rates, a new Journal of General Internal Medicine study finds.

Using 2007 Medicare hospital data, Baystate Medical Center researchers assessed readmission rates and patient outcomes for various conditions, including acute myocardial infarction (AMI), heart failure, pneumonia, abdominal surgery, cardiac surgery, and orthopedic surgery.

Researchers also determined the percentage of patients who received all of the recommended care for their respective conditions. They found that adherence to care processes varied based on the condition. For example, hospital staff completed all the recommend care processes for about 46% of abdominal surgery patients and 88% of AMI patients.

However, the researchers found little correlation between adherence to care guidelines and "meaningfully" lower readmissions rates. "Even when the associations were statistically significant, the differences in the readmission rates of high- and low-performing hospitals were small," the study says.

The team notes care protocols may have "little impact on the risk of readmission" or that the guidelines may be too broadly defined (Seaman, Reuters, 11/8; Stefan et al., Journal of General Internal Medicine, 10/16).

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