Two local hospitals earn high ratings on readmissions

Medicare heart patients at two South Hampton Roads hospitals were less likely than average to need readmission within 30 days of treatment, according to recent federal data.

Bon Secours DePaul Medical Center in Norfolk tallied a superior heart attack readmission rate, and Sentara Bayside Hospital in Virginia Beach listed a heart failure readmission rate better than the U.S. average.

Bayside converted to an outpatient center last month and no longer provides inpatient care. But hundreds of its staff members moved to the newly opened Sentara Princess Anne Hospital in Virginia Beach.

Out of more than 4,500 hospitals evaluated, the two local hospitals were among 161 - and just three in Virginia - to best national average rates of readmission for at least one of three conditions: pneumonia, heart attack or heart failure.

All other Hampton Roads hospitals met national averages for all three conditions.

The federal Centers for Medicare and Medicaid Services started measuring 30-day readmission rates in 2009, saying the rates reflect the quality of care during the patient's initial hospitalization and how well they transition to outpatient care.

Readmission is defined as when a patient who has been hospitalized is admitted again within 30 days of being discharged - whether to the same facility or a different one - for any reason.

The rates cover admissions between July 2007 and June 2010, and are adjusted to account for factors such as how sick patients are upon hospitalization.

Fewer than 1 percent of the hospitals evaluated showed heart attack readmissions better than the national average, and 2.4 percent listed better heart failure readmission rates.

The rates are calculated using records for patients 65 and older who were enrolled in traditional Medicare the entire year before their hospital admission.

The national average and the hospital's past performance were combined in a complex statistical procedure, which corrected for how sick patients were when they arrived at a hospital and other factors, including age and whether the patient has a history of dementia.

Using the numerical calculations, Medicare rated each hospital as worse than average, average or better than average, for each condition.

Beginning October 2012, Medicare inpatient payments will be reduced for hospitals with excess readmissions for the three conditions.

DePaul leaders cited several reasons for its rate, including developing extensive patient-education packets and emphasizing the importance of appropriate medications both during and after a patient's hospital stay.

"One of the biggest things, I've found, is talking to the families," said Dr. Marc J. Rosenberg, a cardiologist who practices at DePaul.

Bon Secours' home health services and partnerships with primary care providers, such as Park Place Medical Center, also have helped, he said.

Sentara Bayside benefited from strong relationships between inpatient and outpatient physicians to keep its readmission rate down, said Dr. Gene Burke, Sentara Healthcare's vice president of clinical effectiveness. Early adoption of the electronic medical records system also contributed.

"We feel that that robustness of connection - communication - is part of why we've done a good job there," he said.

Not everyone agrees that a hospital should be held responsible for patient readmission rates, however.

Some say that outside factors - such as the availability and quality of primary care and other outpatient services in a community - are more significant predictors of whether a patient will return to a hospital.

"Whether you are readmitted to the hospital or not is really affected by a whole lot of things the hospital cannot really control," said Dr. Ashish Jha, an associate professor at the Harvard School of Public Health, who studies hospital quality.

Amy Jeter, (757) 446-2730, amy.jeter@pilotonline.com