We Need to Use Better Data to Measure Quality

It appears that patient characteristics outside of a hospital’s control account for a large amount of the variation seen in readmissions, above and beyond the quality of the hospital’s performance.  This is something that won’t surprise those who follow the medical literature. Many other studies have found that hospital racial make up, individual patient race and socioeconomic status, insurance, education, and home environment all play significant roles in readmission risk. The problem here isn’t just that Medicare isn’t adjusting for these characteristics. It’s that Medicare can’t possibly adjust for those characteristics. The data aren’t known.