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Potentially Preventable Readmissions

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Who gets the “credit” for a preventable readmission

The hospital that is the locus of the initial admission

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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

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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.