In an article released by JAMA Pediatrics today, my co-authors and I show that social determinants of health (patient factors such as health insurance, poverty and other sociodemographic measures) are risk factors for readmissions-related penalties for children’s hospitals. Without adjusting pay-for-performance (P4P) measures for social determinants of health (SDH), hospitals may receive penalties partially related to patient SDH factors beyond the quality of hospital care.
Risk adjustment for SDH may reduce penalizing hospitals for patient factors beyond their control. When we calculated hospital rates on a readmissions-based P4P measure, we found that risk adjusting the readmissions measure for SDH changed the penalty status of 7.0% and 11.6% of hospitals using 15-day and 30-day readmission windows, respectively.
For more on readmissions-related research and policy, see my recent post. A great post on readmissions risk-adjustment is here.
Marion R. Sills, MD, MPH 
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