Debate on Effects of Social Determinants on Hospital Readmissions Continues

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A report finding no connection between sociO-economic status and readmissions rates is being faulted for its lack of granularity by advocates for safety net hospitals.

Debate on Effects of Social Determinants on Hospital Readmissions Continues

The ongoing debate about the role of socio-economic status in hospital readmissions was rekindled this month with a report in Health Affairs showing no connection between the two.

“Our paper should not be interpreted to suggest that socioeconomic disparities in health do not exist,” Susannah M. Bernheim, MD, MHS, director, Quality Measurement Programs at the Yale-New Haven Hospital Center for Outcomes Research and Evaluation (CORE), said in an email exchange with HealthLeaders Media.

“Socioeconomic status is an important determinant of health status,” she says. “What we have shown is that for quality measures, like the readmission measures that already account for differences in patient illness, socioeconomic indicators do not have a big additional effect on hospital results.”

America’s Essential Hospitals, an association representing safety net hospitals, took issue with the findings and said it relies upon ZIP code-level data that doesn’t provide enough granularity about specific neighborhoods and streets where some safety net patients reside, or what goes on inside those homes.

“We believe the authors of the article have not truly identified the data that can help tease out the variables in geographic areas to fully understand why some neighborhoods are more likely to see readmissions than others,” says Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals.

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