Including Sociodemographic Factors In Risk-Adjusted Readmission Measures
Risk adjustment for publicly reported health outcome measures is intended to allow for meaningful comparisons of measured quality differences between hospitals that are attributable to characteristics of the hospitals, as opposed to differing characteristics of their patients or random variation. Risk adjustment for patient-level clinical acuity and basic demographic factors, such as age and gender, are commonplace. However, a growing body of research is emerging around individual- and community-level social factors associated with hospital readmission risk. In August 2014, an expert panel convened by the National Quality Forum made recommendations to include social determinants in risk-adjustment models used for public reporting and other accountability applications.
On Feb. 3, the Missouri Hospital Association will launch Focus on Hospitals, a public transparency website that reports readmission rates for participating hospitals that are adjusted for patients’ sociodemographic status. Specifically, the models include Medicaid status and the poverty rate of a patient’s home census tract. The models also are designed to account for community-level risk factors by nesting the data at the census-tract level.