Community factors and hospital wide readmission rates: Does context matter?

Erica S Spatz, Susannah M Bernheim, Leora I Horwitz and Jeph Herrin

PLOS ONE, 2020, vol. 15, issue 10, 1-14

Abstract: Background: The environment in which a patient lives influences their health outcomes. However, the degree to which community factors are associated with readmissions is uncertain. Objective: To estimate the influence of community factors on the Centers for Medicare & Medicaid Services risk-standardized hospital-wide readmission measure (HWR)–a quality performance measure in the U.S. Research design: We assessed 71 community variables in 6 domains related to health outcomes: clinical care; health behaviors; social and economic factors; the physical environment; demographics; and social capital. Subjects: Medicare fee-for-service patients eligible for the HWR measure between July 2014-June 2015 (n = 6,790,723). Patients were linked to community variables using their 5-digit zip code of residence. Methods: We used a random forest algorithm to rank variables for their importance in predicting HWR scores. Variables were entered into 6 domain-specific multivariable regression models in order of decreasing importance. Variables with P-values

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0240222

DOI: 10.1371/journal.pone.0240222

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