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Using hospital readmission rates to track the quality of care in public hospitals in Singapore

Authors
Journal
BMC Health Services Research
1472-6963
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
11
Identifiers
DOI: 10.1186/1472-6963-11-s1-a16
Keywords
  • Meeting Abstract
Disciplines
  • Medicine

Abstract

Using hospital readmission rates to track the quality of care in public hospitals in Singapore MEETING ABSTRACT Open Access Using hospital readmission rates to track the quality of care in public hospitals in Singapore E Lim*, N Matthew, W Mok, S Chowdhury, D Lee From 27th Patient Classification Systems International (PCSI) Working Conference Montreal, Canada. 19-22 October 2011 Research objectives Singapore introduced Casemix-based financing for inpa- tient and day-surgery cases in the public sector in 1999. The application of Casemix has since been extended beyond financing to fields such as benchmarking, clini- cal quality and utilization review. Casemix data has been invaluable in enabling the tracking and better under- standing of quality of care of healthcare providers, as well as providing a view to better managing them. In this paper, we discuss the use of Casemix data based on a recent study of hospital readmission rates. The study subsequently led to the incorporation of this indicator into the Ministry of Health’s Scorecard for Acute Hospitals. Methods Hospital administrative data of inpatients admitted to public hospitals in Singapore during 2006–2010 were analyzed. 30-day readmission rates were calculated after excluding ‘transfers-out’, ‘in-hospital deaths’, and cases with certain underlying conditions that might potentially affect the risk of readmission (for example, cancer, HIV, trauma). The rates were further adjusted for patients’ Casemix using multivariate logistic linear regression modeling to ensure like-for-like comparisons when com- paring hospitals and evaluating trends over time. Factors for adjustment included age, gender, Charlson comor- bidity index, and past hospitalization. Readmission rates were analysed at the ‘All cause’ level as well as at the ‘Condition-specific’ level; i.e., for seven selected conditions: asthma, AMI, CHF, COPD, diabetes, pneumonia, and stroke. Results In 2010 the crude ‘All cause’ 30-day readmission rate was 11.6%. Of

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