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A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States

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  • Kristensen, Søren Rud
  • Bech, Mickael
  • Quentin, Wilm
Abstract
Hospital readmissions receive increasing interest from policy makers because reducing unnecessary readmissions has the potential to simultaneously improve quality and save costs. This paper reviews readmission policies in Denmark, England, Germany and the United States (Medicare system). The suggested roadmap enables researchers and policy makers to systematically compare and analyse readmission policies. We find considerable differences across countries. In Germany, the readmission policy aims to avoid unintended consequences of the introduction of DRG-based payment; it focuses on readmissions of individual patients and hospitals receive only one DRG-based payment for both the initial and the re-admission. In Denmark, England and the US readmission policies aim at quality improvement and focus on readmission rates. In Denmark, readmission rates are publicly reported but payments are not adjusted in relation to readmissions. In England and the US, financial incentives penalise hospitals with readmission rates above a certain benchmark. In England, this benchmark is defined through local clinical review, while it is based on the risk-adjusted national average in the US. At present, not enough evidence exists to give recommendations on the optimal design of readmission policies. The roadmap can be a tool for systematically assessing how elements of other countries’ readmission policies can potentially be adopted to improve national policies.

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  • Kristensen, Søren Rud & Bech, Mickael & Quentin, Wilm, 2015. "A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States," Health Policy, Elsevier, vol. 119(3), pages 264-273.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:3:p:264-273
    DOI: 10.1016/j.healthpol.2014.12.009
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    Cited by:

    1. Fournaise, Anders & Andersen-Ranberg, Karen & Lauridsen, Jørgen T. & Espersen, Kurt & Gudex, Claire & Bech, Mickael, 2023. "Conceptual framework for acute community health care services – Illustrated by assessing the development of services in Denmark," Social Science & Medicine, Elsevier, vol. 324(C).
    2. Møller Dahl, Christian & Planck Kongstad, Line, 2017. "The costs of acute readmissions to a different hospital – Does the effect vary across provider types?," Social Science & Medicine, Elsevier, vol. 183(C), pages 116-125.
    3. Domenico Lisi & Luigi Siciliani & Odd Rune Straume, 2020. "Hospital competition under pay‐for‐performance: Quality, mortality, and readmissions," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 29(2), pages 289-314, April.
    4. Søren Rud Kristensen, 2017. "Financial Penalties for Performance in Health Care," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 143-148, February.
    5. Quentin, Wilm & Geissler, Alexander & Wittenbecher, Friedrich & Ballinger, Geoff & Berenson, Robert & Bloor, Karen & Forgione, Dana A. & Köpf, Peer & Kroneman, Madelon & Serden, Lisbeth & Suarez, Raúl, 2018. "Paying hospital specialists: Experiences and lessons from eight high-income countries," Health Policy, Elsevier, vol. 122(5), pages 473-484.
    6. Andrea S Gershon & Deva Thiruchelvam & Shawn Aaron & Matthew Stanbrook & Nicholas Vozoris & Wan C Tan & Eunice Cho & Teresa To, 2019. "Socioeconomic status (SES) and 30-day hospital readmissions for chronic obstructive pulmonary (COPD) disease: A population-based cohort study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    7. Damien Bricard & Zeynep Or, 2018. "Does an Early Primary Care Follow-up after Discharge Reduce Readmissions for Heart Failure Patients?," Working Papers DT73, IRDES institut for research and information in health economics, revised Mar 2018.
    8. Lobo, Mariana F & Azzone, Vanessa & Lopes, Fernando & Freitas, Alberto & Costa-Pereira, Altamiro & Normand, Sharon-Lise & Teixeira-Pinto, Armando, 2020. "Understanding the large heterogeneity in hospital readmissions and mortality for acute myocardial infarction," Health Policy, Elsevier, vol. 124(7), pages 684-694.
    9. Damien Bricard & Zeynep Or, 2019. "Impact of early primary care follow-up after discharge on hospital readmissions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 611-623, June.
    10. Ambugo, Eliva Atieno & Hagen, Terje P., 2019. "Effects of introducing a fee for inpatient overstays on the rate of death and readmissions across municipalities in Norway," Social Science & Medicine, Elsevier, vol. 230(C), pages 309-317.

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