Readmission Patterns Over 90-Day Episodes of Care Among Medicare Fee-for-Service Beneficiaries Discharged to Post-acute Care.

Claims data may have inaccurate or incomplete coding. It did not risk adjust, so rates across skilled nursing, inpatient rehabilitation, and home health may reflect differences in patient severity rather than care quality. It excluded people in Medicare Advantage, people who died within 90 days, people transferred to another hospital, and people admitted from long-term care or post-acute care. It only included stroke, lower extremity joint replacement, and hip/femur fracture, so it does not apply to other conditions or the full Medicare population. Social factors such as education, financial status, and social support were not measured.

The authors reported no conflicts of interest. The paper was supported by U.S. government and NIH research funding.

Do not read higher readmission in skilled nursing as proof that skilled nursing care causes readmission. The study did not risk adjust, so patients in different settings may have differed in illness severity and needs.