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This article explores the complexities surrounding potentially preventable readmissions (PPRs), focusing on mental health conditions. It discusses how PPRs for mental health are evaluated similarly to other chronic diseases, such as diabetes, emphasizing that readmissions are often considered preventable. The piece explains the adjustments made in the Actual to Expected (A/E) calculation for institutions handling higher volumes of mental health and substance abuse (MH/SA) patients. It highlights how these adjustments offer greater protection to hospitals due to historically higher readmission rates among MH/SA patients.
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Who gets the “credit” for a preventable readmission • The hospital that is the locus of the initial admission
PPRs and Mental Health • Readmissions for mental health conditions are treated no differently, from a preventability point of view, than any other chronic condition such as diabetes. • For example, all patients who have diabetes and are readmitted for virtually any chronic medical condition (e.g. CHF) are considered to have had a preventable readmission
The Actual To Expected Calculation IS Different for Mental Health/ Substance Abuse Services • The Actual To Expected calculation is adjusted for the presence/absence of principal and/or secondary diagnoses of MH/SA. • The reason is that patients with mental health conditions in the initial admission historically have had higher rates of readmissions. • Those institutions that take on larger numbers of MH/SA patients will have greater protection because the A/E computation adjustment takes into account the higher rates of readmissions for patients with significant MH/SA conditions.
