Readmission Rate Calculator
Total eligible patients discharged during the period.
Patients who returned within the specified window (e.g., 30 days).
Calculated Readmission Rate
0.00%
How is Readmission Rate Calculated?
In healthcare analytics and quality improvement, the hospital readmission rate is a critical key performance indicator (KPI). It measures the percentage of patients who experience an unplanned readmission to a hospital within a specific time interval after being discharged from an initial hospitalization (known as the "index admission").
The standard time frame used by the Centers for Medicare & Medicaid Services (CMS) and most healthcare organizations is 30 days. High readmission rates may indicate issues with the quality of care, discharge planning, or post-discharge follow-up.
The Readmission Rate Formula
The basic formula for calculating the raw readmission rate is relatively straightforward:
(Number of Readmissions ÷ Total Number of Index Discharges) × 100
Where:
- Total Number of Index Discharges: The total count of eligible patients discharged alive from the hospital during the measurement period. This constitutes the denominator.
- Number of Readmissions: The subset of those discharged patients who returned to an acute care hospital within the specified window (e.g., 30 days). This constitutes the numerator.
Real-World Example
Let's look at a practical example to understand how the math works in a clinical setting.
Scenario: General Hospital tracks its heart failure patients for the month of July.
1. Total Discharges: The hospital discharged 250 eligible heart failure patients.
2. Readmissions: Within 30 days of their respective discharges, 35 of these patients were readmitted to the hospital.
Calculation:
35 (Readmissions) ÷ 250 (Discharges) = 0.14
0.14 × 100 = 14.00%
1. Total Discharges: The hospital discharged 250 eligible heart failure patients.
2. Readmissions: Within 30 days of their respective discharges, 35 of these patients were readmitted to the hospital.
Calculation:
35 (Readmissions) ÷ 250 (Discharges) = 0.14
0.14 × 100 = 14.00%
Why Readmission Rates Matter
Understanding how readmission rate is calculated is essential for hospital administrators and clinicians for several reasons:
- Financial Penalties: Under the Hospital Readmissions Reduction Program (HRRP), CMS reduces payments to hospitals with excess readmissions.
- Quality of Care: It serves as a proxy for the quality of care coordination and discharge planning.
- Patient Outcomes: Reducing readmissions generally means patients are recovering better at home and managing their conditions effectively.
Exclusions and Adjustments
While the calculator above provides the raw readmission rate, official reporting often involves risk adjustments. Not all readmissions are counted in official metrics. Common exclusions include:
- Planned readmissions (e.g., scheduled chemotherapy or staged surgeries).
- Transfers to other acute care facilities.
- Patients who leave against medical advice (AMA).
When calculating your internal metrics, ensure you have clearly defined which discharges are "eligible" for the denominator to ensure data accuracy.