By: Saparja Nag  Feb. 19, 2018
According to an analysis of CMS Medicare claims data by Dexur, Mercy Medical Center - Dubuque readmitted the lowest proportion of heart failure patients within 30 days of all hospitals in Iowa, with a rate of 14.11% in 2016. They have held to this standard of care over the years as they had the lowest heart failure readmission rate between 2013 and 2016 as well at 16.26%. The top six ranked hospitals for lowest readmission rate remained the same over these two time periods, albeit not in the same order. These hospitals included three other campuses of Mercy Medical Center - Cedar Rapids, North Iowa, and Des Moines - as well as Iowa Methodist Medical Center and UnityPoint Health - St. Luke’s Hospital.
The hospitals included in this study had to meet two criteria: at least 3,500 total Medicare inpatient discharges and at least 11 discharges for DRG-291 in 2016. DRG-291 is one of three DRGs included under heart failure and is defined as heart failure and shock with major complication or comorbidity. As the highest volume heart failure DRG during both time periods at the state and national levels, DRG-291 was the most appropriate as it provided a large sample size for more accurate analysis of readmission rates. In 2016, there were 274,735 discharges in the nation and 2,812 in the state alone for this DRG. Between 2013 and 2016, DRG-291 discharges reached 928,222 discharges nationally and 9,717 discharges from Iowa.
The difference between the readmission rates for 2013 - 2016 provides a perspective into how regions and hospitals are changing over time, ideally improving their quality metrics as they develop more advanced treatments. At the national level, the readmission rate for DRG-291 has remained exactly the same at 28.42%. The state readmission rate dropped 0.91% from 23.07% to 22.16%. The six hospitals shown in the graph above had the lowest DRG-291 readmission rates in 2016, five of which experienced a decrease in readmission rate from 2013 - 2016. The largest drop in readmission rate was found at Mercy Medical Center - North Iowa, which experienced a 3.96% decrease. This improved their ranking in the state for lowest readmission rate for DRG-291 from 6th to 3rd. The top ranked Mercy Medical Center - Dubuque had the second highest change of 2.15% from 2013 - 2016 to 2016.