The 3M Potentially Preventable Readmissions measure was developed as an effort to more efficiently identify readmissions and improve on the CMS readmission data posting system. However, new research suggests the PPR measure may not clearly distinguish differences in care quality between readmissions that are preventable and those that aren't.
The 3M system identifies readmissions with diagnoses that are clinically related to those that prompted a patient's initial admission in order to flag which could have been avoided. Researchers looked at the medical records of 100 randomly selected cases from a pool of more than 11,000 readmissions in order to evaluate the quality of care those patients had received both in-hospital and post-discharge. Quality of care is a key factor involved in readmission.
Among the 77 cases that were flagged as PPRs, the quality of care was slightly better than the 23 cases that were not flagged. Although the results were not statistically significant, the researchers conclude that either PPR cases are not more preventable or that the metrics used for assessing preventability require other data collection methods.
Ultimately, researchers write that readmissions may be too crude a measure, and not center on patients.
"The time has come to shift the focus of readmissions away from hospitals to a broader health systems approach," the authors wrote. "Rather than focusing on readmissions, preventable or otherwise, time may be better spent in developing quality measures of complex disease management across a patient's continuum of care."