Analysis of hospital readmissions with competing risks.

ABSTRACT: The 30-day hospital readmission rate has been used in provider profiling for evaluating inter-provider care coordination, medical cost effectiveness, and patient quality of life. Current profiling analyzes use logistic regression to model 30-day readmission as a binary outcome, but one disadvantage of this approach is that this outcome is strongly affected by competing risks (e.g., death). Thus, one, perhaps unintended, consequence is that if two facilities have the same rates of readmission, the one with the higher rate of competing risks will have the lower 30-day readmission rate. We propose a discrete time competing risk model wherein the cause-specific readmission hazard is used to assess provider-level effects. This approach takes account of the timing of events and focuses on the re

SUBMITTER: Wu W 

PROVIDER: S-EPMC9931495 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature