Challenges and opportunities associated with quantification of cardiovascular readmissions

With increasing use and collection of administrative and registry data, there is real need to focus on the importance of quality reporting and documentation. Current research from a Canadian group highlights the importance and challenges associated with this very issue. In their study, the authors report that readmissions to the hospital after an acute coronary syndrome (ACS) hospitalization are common. Their cohort included data from 3411 patients post ACS with primary outcomes being 30‐day and 1‐year hospital readmissions. Their results demonstrate that one third of ACS patients had a readmission within 30 days and two thirds had a readmission within 1 year. Around half of the readmissions were for cardiovascular reasons and around 45% were presentations to an emergency department only. However, in their conclusion they identify that the rate of readmission at 30 days may not be an ideal measure of hospital performance primarily due to their heterogeneous nature. Southern and colleagues raise discussion about whether readmissions after ACS are indeed avoidable. The issue of inherent reliance on administrative data documented at the hospital level is also raised. Similar results are evident in a similar report from the Australia and New Zealand SNAPSHOT ACS study, which has also captured clinical characteristics, management, and outcomes of 4398 patients hospitalized with ACS from 478 participating Australian and New Zealand hospitals.