Social determinants of health and pay-for-performance readmissions measures

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.Screen Shot 2016-02-15 at 2.32.48 PM

For more on readmissions-related research and policy, see my recent post. A great post on readmissions risk-adjustment is here.


Published by Marion Sills

I am a Professor of Pediatrics and Emergency Medicine at the University of Colorado. I work as a physician in the emergency departments of the Children's Hospital of Colorado and as a health services researcher at the University's Adult and Child Consortium for Health Outcomes (ACCORDS).

One thought on “Social determinants of health and pay-for-performance readmissions measures

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: