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Importance: The Affordable Care Act has led to US national reductions in hospital 30-day readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. Whether readmission reductions have had the unintended consequence of increasing mortality after hospitalization is unknown.Objective: To examine the correlation of paired trends in hospital 30-day readmission rates and hospital 30-day mortality rates after discharge.Design, Setting, and Participants: Retrospective study of Medicare fee-for-service beneficiaries aged 65 years or older hospitalized with HF, AMI, or pneumonia from January 1, 2008, through December 31, 2014.Exposure: Thirty-day risk-adjusted readmission rate (RARR).Main Outcomes and Measures: Thirty-day RARRs and 30-day risk-adjusted mortality rates (RAMRs) after discharge were calculated for each condition in each month at each hospital in 2008 through 2014. Monthly trends in each hospital's 30-day RARRs and 30-day RAMRs after discharge were examined for each condition. The weighted Pearson correlation coefficient was calculated for hospitals' paired monthly trends in 30-day RARRs and 30-day RAMRs after discharge for each condition.Results: In 2008 through 2014, 2 962 554 hospitalizations for HF, 1 229 939 for AMI, and 2 544 530 for pneumonia were identified at 5016, 4772, and 5057 hospitals, respectively. In January 2008, mean hospital 30-day RARRs and 30-day RAMRs after discharge were 24.6% and 8.4% for HF, 19.3% and 7.6% for AMI, and 18.3% and 8.5% for pneumonia. Hospital 30-day RARRs declined in the aggregate across hospitals from 2008 through 2014; monthly changes in RARRs were -0.053% (95% CI, -0.055% to -0.051%) for HF, -0.044% (95% CI, -0.047% to -0.041%) for AMI, and -0.033% (95% CI, -0.035% to -0.031%) for pneumonia. In contrast, monthly aggregate changes across hospitals in hospital 30-day RAMRs after discharge varied by condition: HF, 0.008% (95% CI, 0.007% to 0.010%); AMI, -0.003% (95% CI, -0.005% to -0.001%); and pneumonia, 0.001% (95% CI, -0.001% to 0.003%). However, correlation coefficients in hospitals' paired monthly changes in 30-day RARRs and 30-day RAMRs after discharge were weakly positive: HF, 0.066 (95% CI, 0.036 to 0.096); AMI, 0.067 (95% CI, 0.027 to 0.106); and pneumonia, 0.108 (95% CI, 0.079 to 0.137). Findings were similar in secondary analyses, including with alternate definitions of hospital mortality.Conclusions and Relevance: Among Medicare fee-for-service beneficiaries hospitalized for heart failure, acute myocardial infarction, or pneumonia, reductions in hospital 30-day readmission rates were weakly but significantly correlated with reductions in hospital 30-day mortality rates after discharge. These findings do not support increasing postdischarge mortality related to reducing hospital readmissions. [ABSTRACT FROM AUTHOR]

The article examines the association between hospital readmission and mortality rates for cardiac patients who were presented with clinical case of acute myocardial infarction, heart failure and pneumonia. It highlights the impact of quality of medical care provided by health care centers in resolving the risk associated with cardiac patients. The Centers for Medicare & Medicaid Services in the U.S. on the basis of a cohort analysis revealed that differences in performance of hospitals and diagnostic parameters implied by hospital were of immense use in determination of readmission rate and mortality rate of cardiac patients.

The article focuses on a study regarding the evaluation of readmission and timing among Medicare beneficiaries who are readmitted for heart failure (HF), acute myocardial infarction (MI) and pneumonia. It mentions that hospital readmissions report poor health care facility and states that the U.S. Centers for Medicare and Medicaid Services (CMS) has started public reporting of outcomes for improving the hospital care quality. The study reveals that 30-day readmissions were frequent throughout the month after rehospitalization for HF, MI and pneumonia. It also presents statistics which depict the readmission of patients.

The article focuses on a study which was designed to characterize the attitudes, experiences and training expectations of general surgery residents in the U.S. The study included a survey of all general surgery residents and was conducted after the American Board of Surgery In-Training Examination. Most of the study subjects claimed that they are satisfied with training and supportive peer relationships. However, there are residents who reported unmet needs and apprehensions related to training and careers. Study authors concluded that the attitude, experiences and training expectations of general surgery residents reflect high levels of satisfaction.