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Older adults treated at Jefferson Health hospitals are more likely to end up back in the hospital within 30 days, compared to patients at other Philadelphia-area hospitals and nationally.

An Inquirer analysis of an important quality metric — the rate at which patients using the government’s Medicare health coverage are readmitted to the hospital unexpectedly — found that readmission rates for most hospitals in the Philadelphia region are about the same as the national average.

But nine of Jefferson’s 12 general acute-care hospitals in the Philadelphia region performed below the national benchmark in 2023. This raises questions about whether system-level factors could be contributing to the problem, said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation.

“The hospitals cover a broad range of neighborhood types, so it is hard to imagine patient factors that could explain everything you are seeing,” she said in an email.

It’s hard to draw clear conclusions in part because Jefferson has eight hospitals operating under three shared licenses, meaning the performance of each set is reported together. The region’s highest readmission rates were reported by a trio of Jefferson hospitals in South Jersey operating under a shared license: Jefferson’s Stratford, Cherry Hill and Washington Township hospitals had a readmission rate of 17.4%.

CMS tracks so-called 30-day readmission rates among Medicare patients who are 65 years or older, because high readmission rates can indicate subpar care or a lack of planning for treatment needed upon leaving the hospital. Avoiding unnecessary hospital time is also considered critical to controlling health-care costs.

The most recently released data track readmissions during the one-year period between July 2022 and end of June 2023.

On the national level, 14.6 percent of the Medicare patients tracked were unexpectedly readmitted to the hospital during that time. The calculation does not include patients with privately administered Medicare Advantage plans or people younger than 65 who qualify for the government-funded health coverage because of a disability.

In the Philadelphia region, several Jefferson hospitals, including Abington, the flagship Thomas Jefferson University Hospital and the three hospitals that operate as Jefferson Northeast — Torresdale, Frankford and Bucks — were clustered with the worst readmission rates, along with the Jefferson Stratford trio.

Penn Presbyterian Medical Center and Chestnut Hill Hospital had the lowest readmission rate in the area at 14%.

No Philadelphia-area hospitals were considered high performing under a system that scores hospitals as worse, same, or better than a national benchmark.

In calculating readmissions rates, CMS accounts for patient considerations that can fuel hospital readmissions. For example, patients who are older, live below the poverty rate, struggle with multiple chronic conditions, and don’t have at-home support are more likely to be readmitted to the hospital.

CMS uses an algorithm that accounts for such differences in patients, to make it easier to compare hospitals on their readmission rates.

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Hospitals have more control over other influential factors, such as the discharge plan for a patient, whether the patient experienced any complications or infections during their stay, and access to medical professionals outside the hospital, said Hempstead, the Robert Wood Johnson Foundation policy adviser.

As for why almost all of one system’s hospitals — geographically spread among Philadelphia’s poorer neighborhoods and affluent suburbs — reported worse readmission rates, Hempstead said system-level factors could be to blame. This could reflect policies that push staff to get patients home as soon as possible or inadequate resources for patients when they’re being discharged.

A spokesperson for Jefferson Health said the system is aware of the need to improve readmission rates but declined to offer specifics about what administrators think is contributing to the problem.

“We are actively working to address these challenges and focusing on how the health-related social needs of our patients intersect with readmissions,” Damien Woods, a spokesperson for Jefferson, said in a statement.

The system is focusing on improving “care transitions,” by ensuring that patients at high risk for readmission receive a follow-up visit within seven days, he said.

Check out the interactive table below to see how your hospital fares.