Patient Readmission Rate (PRR)
Last updated: Sep 12, 2025
What is Patient Readmission Rate?
Patient Readmission Rate is a key performance indicator in healthcare that measures the percentage of patients who are readmitted to a hospital within a specific timeframe after their initial discharge. While the timeframe can vary, a 30-day period is commonly used. This metric is a crucial gauge of the quality of care provided by a hospital and the effectiveness of its discharge planning and transitional care. A lower readmission rate is generally seen as a sign of better care and improved health system efficiency, as it suggests that patients are receiving appropriate and effective care both in the hospital and after they return home.
Patient Readmission Rate Formula
How to calculate Patient Readmission Rate
Let's consider a hospital, "St. Mary's," that wants to calculate its 30-day readmission rate for a specific quarter. - Number of Discharges (Index Admissions): 5,000 - Number of Unplanned Readmissions within 30 days: 650 Using the basic formula, St. Mary's can calculate its unadjusted readmission rate: Patient Readmission Rate = 650 / 5,000 X 100% = 13% This rate indicates that 13% of patients discharged from St. Mary's during that quarter were readmitted within 30 days. Now, let's consider the more detailed, risk-adjusted calculation used by many healthcare systems. This approach accounts for the specific patient mix a hospital serves, which might include a higher proportion of elderly or chronically ill patients. - Predicted Readmissions: Based on a hierarchical regression model that considers the hospital's specific patient case mix and quality of care, the model predicts that 650 of St. Mary's patients would be readmitted. - Expected Readmissions: If those same patients were treated at an "average" hospital, the model expects 700 readmissions. - Average Readmission Rate: Let's assume the national average is 10%. Using the risk-adjusted formula, St. Mary's rate would be: Risk?Adjusted Readmission Rate= 650 / 700 X 10% = 9.3% In this example, the risk-adjusted rate (9.3%) is lower than the unadjusted rate (13%), which suggests that St. Mary's is performing better than the national average, especially when considering the complexity of its patient population.
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What is a good Patient Readmission Rate benchmark?
The average hospital readmission rate in the U.S. is approximately 14.67%, with rates among reporting hospitals ranging from 10.1% to 19.1%. The 30-day all-cause hospital readmission rate for all payers in the U.S. has remained relatively stable at 13.9 per 100 index admissions from 2016 to 2020. In Canada, one in 11 patients are readmitted to the hospital within 30 days of discharge. Readmission rates can vary significantly by patient characteristics, such as age and race, and by specific medical conditions. For example, in 2020 in the U.S., the readmission rate for hospital stays among non-Hispanic Black patients was 16.0 per 100 index admissions, while it was 11.7 for non-Hispanic Asian/Pacific Islander patients. For certain conditions, such as blood diseases, the readmission rate was as high as 23.8 per 100 index admissions in 2020.
More about Patient Readmission Rate
The patient readmission rate is a widely used and important metric for evaluating healthcare quality, but it is a complex measure that requires careful analysis. While a low rate is desirable, it's not always a straightforward indicator of quality. A readmission rate of zero, for example, is not feasible and may even suggest poor care, as some readmissions are medically necessary and unavoidable. The proportion of readmissions that are truly preventable can vary significantly, with some studies suggesting a median of 27%.
Healthcare systems in Canada and the United States use readmission rates to measure quality of care and identify areas for improvement. The United States' Hospital Readmissions Reduction Program (HRRP) is a notable example, which has imposed financial penalties on hospitals with high unplanned readmission rates since 2012. This program has been credited with a reduction in readmission rates for Medicare beneficiaries, though it has also faced challenges, such as the emergence of loopholes. In Canada, unplanned hospital readmissions are also a significant issue, costing the system billions of dollars annually. For this reason, there is a focus on innovative prevention methods, such as patient-centred models of care.
Readmission rates can be influenced by a wide variety of factors beyond the quality of inpatient care, including the effectiveness of care coordination and transition, the availability of community-based disease management programs, and patient-level factors like age, socioeconomic status, and underlying health conditions. For example, studies have found that patients with certain diagnoses, such as heart failure, have a higher likelihood of readmission. To account for these variables, many healthcare systems use risk-adjusted readmission rates, which factor in the characteristics of the patient population to provide a more accurate comparison between hospitals.
To reduce patient readmission rates, a multi-faceted approach is often required. Single interventions are typically less effective than multi-component strategies that span both inpatient and outpatient settings. Best practices for reducing readmissions often focus on improving the transition from hospital to home. These strategies include:
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Comprehensive Discharge Planning: Ensuring patients and their caregivers have a clear, easy-to-understand plan for their care after they leave the hospital.
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Patient and Caregiver Education: Teaching patients and their families about medication management, recognizing "red flag" symptoms, and understanding their health conditions.
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Timely Follow-up: Scheduling and encouraging timely post-discharge appointments with primary care physicians or specialists. This can be a key factor in reducing readmissions, and some initiatives, like the "See You in 7" program, aim for appointments within seven days of discharge.
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Care Coordination: Improving communication between hospital staff, community physicians, and other care providers.
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Telephone or Remote Monitoring: Having a designated person, such as a nurse or care coach, follow up with the patient after discharge to answer questions and ensure they are following their care plan. Remote patient monitoring through telehealth can also be an effective tool.
Implementing these strategies can help to improve patient outcomes, reduce costs, and increase the overall value of care provided by a health system.
Patient Readmission Rate Frequently Asked Questions
Are all patient readmissions a sign of poor quality of care?
Not necessarily. While many readmissions are preventable, some are medically appropriate and unavoidable, such as a patient being readmitted for a new, unrelated condition. The goal is not to achieve a zero readmission rate but to reduce avoidable ones through improved care coordination and discharge planning.
What is the difference between an unadjusted and a risk-adjusted readmission rate?
An unadjusted rate is a raw percentage of readmissions, while a risk-adjusted rate takes into account the characteristics of a hospital's patient population, such as age, gender, and pre-existing conditions. The risk-adjusted rate provides a more accurate comparison of hospital performance by levelling the playing field.
What are the main causes of avoidable hospital readmissions?
Avoidable readmissions often stem from inadequate discharge planning, poor patient education, and a lack of follow-up care or support after leaving the hospital. Problems with medication reconciliation and a patient's inability to manage their own care at home are also significant factors.