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Readmission Rate: Experience in USA, Canada and UK

미국, 캐나다, 영국의 재입원율 활용 현황

  • Lee, Sang-Ah (Department of Public Health, Graduate School, Yonsei University) ;
  • Ju, Yeong-Jun (Department of Public Health, Graduate School, Yonsei University) ;
  • Shin, Jae-Yong (Institute of Health Service Research, Yonsei University) ;
  • Park, Eun-Cheol (Institute of Health Service Research, Yonsei University) ;
  • Lee, Hoo-Yeon (Department of Social Medicine, College of Medicine, Dankook University)
  • 이상아 (연세대학교 일반대학원 보건학과) ;
  • 주영준 (연세대학교 일반대학원 보건학과) ;
  • 신재용 (연세대학교 보건정책관리연구소) ;
  • 박은철 (연세대학교 보건정책관리연구소) ;
  • 이후연 (단국대학교 의과대학 인문사회의학교실)
  • Received : 2016.05.23
  • Accepted : 2016.06.14
  • Published : 2016.06.30

Abstract

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

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