Hospital participation in Meaningful Use and racial disparities in readmissions

Am J Manag Care. 2018 Jan;24(1):38-42.

Abstract

Objectives: To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race.

Study design: A retrospective cohort study that compared the likelihood of 30-day readmission for Medicare beneficiaries discharged from hospitals participating in Stage 1 of MU with the likelihood of readmission for beneficiaries concurrently discharged from hospitals that were not participating in the initiative.

Methods: Inpatient claims for 2,414,205 Medicare beneficiaries from Florida, New York, and Washington State were used as the primary data source. The study period (2009-2013) included at least 2 years of baseline data prior to each hospital initiating participation in MU. Estimates were derived with linear regression models that included hospital and time fixed effects. By including both hospital and time fixed effects, estimates were based on discharges from the same hospital in the same time period.

Results: MU participation among hospitals was not associated with a statistically significant change in readmissions for the broader Medicare population (percentage points [PP], 0.6; 95% CI, -0.2 to 1.4), but hospitals' participation in the initiative was associated with a lower likelihood of readmission for African American beneficiaries (PP, -0.9; 95% CI, -1.5 to -0.4).

Conclusions: Hospital participation in MU reduced disparities in 30-day readmissions for African American Medicare beneficiaries.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Black or African American / ethnology*
  • Black or African American / statistics & numerical data
  • Cohort Studies
  • Female
  • Florida / ethnology
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Male
  • Meaningful Use / statistics & numerical data*
  • Medicare / statistics & numerical data
  • New York / ethnology
  • Patient Discharge / statistics & numerical data*
  • Patient Readmission / statistics & numerical data*
  • Racism / ethnology*
  • Racism / statistics & numerical data
  • Reproducibility of Results
  • Retrospective Studies
  • United States
  • Washington / ethnology