The Centers for Medicare & Medicaid Services (CMS) is a federal organization that is responsible for providing Americans with health coverage and analyzing the quality of care medical facilities. One of the statements supported by the CMS is that inpatient admission prevention should improve the quality of care. Inpatient and prevention are the two main areas in quality control (Fleming & Wackerbarth, 2015). As soon as safety culture is promoted, unnecessary care is removed, and care providers are able to focus on their tasks and obligations thoroughly. To measure readmissions, the CMS recommends monitoring people under age 65 and older, excluding those from cancer hospitals. Such diagnoses as diabetes, chronic obstructive pulmonary disease, hypertension, and angina must be recognized (Fleming & Wackerbarth, 2015). Many current studies show that readmission prevention is characterized by certain benefits in care management. For example, Kong and Wilkinson (2020) discovered that strategies directed to reduce readmission rates among COPD patients lead to increased patient satisfaction, centralized care, and the possibility to reduce costs compared to conventional care. However, many other benefits associated with inpatient readmission have to be investigated.
Quality improvement is also promoted by the implementation of special programs and policies. For example, to predict readmissions, the CMS supports the idea of the Hospital Readmissions Reduction Program to adjust hospital payments and reimbursements on the basis of readmission rates during the last three years. Therefore, today, hospitals are interested in developing new strategies to decrease readmissions. Kong and Wilkinson (2020) offered patient education as a means to improve treatment adherence and promote self-management. The analysis of actual causes of readmissions and the population characteristics are also important steps for avoid readmission-related problems.
Fleming, S. T., & Wackerbarth, S. (2015). Quality of care management. In S. T. Fleming (Ed.), Managerial epidemiology: Cases & concepts (3rd ed, pp. 107-136). Health Administration Press.
Kong, C. W., & Wilkinson, T. M. A. (2020). Predicting and preventing hospital readmission for exacerbations of COPD. ERJ Open Research, 6(2). Web.