AHRQ Introduces First Nationwide Readmission Database

By Christine Kern, contributing writer

Database will be valuable for healthcare analyses and decision-making.

The Agency for Healthcare Research and Quality (AHRQ) has announced the launch of the first-ever Nationwide Readmission Database (NRD), party of the AHRQ-sponsored Healthcare Cost and Utilization Project (HCUP), a group of related databases that includes information from administrative billing data.

The NRD is the first all-payer nationwide database to track hospital readmissions, which remains a critical health policy issue. According to the AHRQ, “The value of the NRD is illustrated in a new HCUP Statistical Brief examining trends in hospital readmission for four high-volume conditions: congestive heart failure, chronic obstructive pulmonary disease, heart attack, and pneumonia.” The brief found there were 500,000 readmissions for these four conditions, costing $6.8 billion in 2013.

The NRD can be used by researchers to create estimates of national readmission rates for all payers and uninsured. This database addresses a large gap in healthcare data — the lack of nationally representative information on hospital readmissions for all ages. Unweighted, the NRD contains data from approximately 14 million discharges each year. Weighted, it estimates roughly 36 million discharges.

Key features of the 2013 NRD include:

• A large sample size, which provides sufficient data for analysis across hospital types and the study of readmissions for relatively uncommon disorders and procedures.
• Discharge data from 21 geographically dispersed States, accounting for 49.3 percent of the total U.S. resident population and 49.1 percent of all U.S. hospitalizations.
• Designed to be flexible to various types of analyses of readmissions in the United States for all types of payers and the uninsured.
• Criteria to determine the relationship between multiple hospital admissions for an individual patient in a calendar year is left to the analyst using the NRD.
• Outcomes of interest include national readmission rates, reasons for returning to the hospital for care, and the hospital costs for discharges with and without readmissions.
• The NRD is designed to support national readmission analyses and cannot be used for regional, State-, or hospital-specific analyses.

HCUP databases include information on 97 percent of all U.S. hospital discharges. The NRD promotes comparative studies of health care services and supports health care policy and research on a variety of topics, including national readmission rates by diagnosis, procedure, patient demographics, or expected payment source; costs associated with readmissions; reasons for readmissions; impact of health policy changes; quality of care; access to care; and utilization of health services by special populations, including the uninsured.