Early Examination of Hospital-Level Performance on Unplanned, Potentially Avoidable Hospital Visits After...

Area of Science:

• Health Services Research
• Quality Improvement in Healthcare
• Oncology Patient Outcomes

Background:

• Medicare introduced a quality measure to reduce potentially avoidable hospital visits post-chemotherapy.
• Assessing the impact of this measure on hospital performance is crucial for healthcare quality.

Purpose of the Study:

• To evaluate changes in potentially avoidable hospital visits (emergency department and inpatient admissions) following chemotherapy.
• To determine if these changes correlate with a specific Medicare quality measure.

Main Methods:

• Retrospective analysis of hospital visit data from 2018-2022.
• Stratified hospitals based on initial visit rates and used regression models to assess changes over time.
• Compared hospital performance against national rates.

Main Results:

• Potentially avoidable emergency department visit rates decreased from 6.0% to 5.4%, and inpatient admission rates from 12.5% to 10.3% nationally.
• Hospitals with higher initial visit rates showed the most significant declines.
• Regression analysis indicated that 9-10.6% of the decline in the highest-quartile hospitals could be attributed to regression toward the mean.

Conclusions:

• Hospitals demonstrated a reduction in potentially avoidable post-chemotherapy visits.
• The majority of hospitals were consistently rated as performing similarly to the national average.
• The direct impact of the Medicare quality measure on these observed reductions remains uncertain.