One of the greatest strengths that home health agencies bring to the medical industry is the support they provide to keep patients out of hospitals through the care they provide. This is why so many of the tables in the Trella Health Solutions provide metrics for % Readmitted: 30 days. This metric provides the percentage of patients from a selected facility who were re-admitted to any hospital within 30 days of discharge from a prior short term acute care stay (inpatient.)
There is a major section of the Home Health Detail page called Readmissions and Hospitalizations by Major Diagnostic Category that includes three tables that provide Readmission and Hospitalization metrics broken down into the 20 Major Diagnostic Categories we use in the Trella Health Solutions. These tables provide insights into the types of care and relative distribution of care provided by the agency from the page.
The first table contains the readmission rates for the agency broken down by the Major Diagnostic Categories.
Understanding the Data
Each row of this table contains one of the 20 MDC's used in the Trella Health Solutions. For each MDC, the row contains:
- The count of distinct patients for whom the MDC in each row is the primary diagnostic category for patients treated by the home health agency on the page.
- Readmission percentages for the MDC in the row for this HHA and comparative percentages for the county and State.
For more information about MDC's see CMS Major Diagnostic Categories (MDC).
Unique Patient Total
The bottom row includes a total count. This total will not equal the sum of the numbers in the row if you add them up because some patients could be represented in more than one row but will only be counted once for the total. (The total is a union of the counts for each row.) In addition, this Total will not be the same as the Total patient counts in any other table on the page because this table is reporting readmission data which only pertains to patients who were discharged from inpatient care to the home health agency. Other counts on this page include patients who would not be included in readmission data. An example of this would be any patient whose last inpatient discharge was longer than 30 days from home care admission.
The use of the word "unique" in this table should be construed as synonymous with the word "distinct" as used throughout the remainder of the Solution.
Aggregated INS MDC's - There is an entry titled, “Aggregated INS MDC’s” which represents the combined percentage for all diagnostic categories that are too small to be presented on their own. In any case where the total number of patients in a specific MDC drops below 11 patients, we can't show that number for privacy reasons. We roll all MDCs that represent counts <11 into this one category and present that count with this header. To examine this header in steps, this row includes all MDC's that have insufficient counts aggregated into a single metric.
Unspecified - Sometimes there is no data on the claim to allow us to identify a specific MDC. When that happens, we put those claims into the category, "Unspecified."
These metrics allow you to identify areas of greater patient demographics within the listed MDC. Then, for any MDC of specific interest, you can evaluate readmission performance against competitors or in general against the county and state averages. In the end, these measures reveal areas of competitive advantage or areas of focus for improvement.
For a more general understanding of Readmission, see the following video.