Background: The 7- and 30-day patient readmission rates are tracked by hospitals and are used as a metric to measure physicians’ quality of patient care. Several tools currently predict and prevent early readmission rates based on patient-specific characteristics. However, few studies have demonstrated if physician-specific characteristics play a role. The purpose of this study is to assess if physician characteristics correlate with patient readmission rates.
Methods: In a five-year retrospective chart review, 31 internal medicine physicians and their hospital discharges were recorded for a total of 15,933 hospital discharges at one academic institution. Each physician’s yearly 7-day, 8-30day (excluding the first 7 days), and 30-day readmission rates were compared to all the other physicians’ rates. Each readmission rate was also correlated with years of post-graduate clinical experience, patient discharge volume, physician gender, and fiscal year. All analyses were performed using SAS 9.4, and statistical significance was set at p≤0.05.
Results: The 7-day readmission rates did not correlate with the 8-30 day rates (p=0.155). Individual physicians had significantly different readmission rates for all readmission rate categories (p=0.001- 0.010). However, the rates were not related to gender, years after post-graduate training., or fiscal year. Physician patient volume was the only identified characteristic that significantly correlated with readmission rates. Physicians who discharged ≤100 patients in a year had a higher 7-day readmission rate, 8.24% (6.76, 9.71), compared to physicians who discharged 101-200 (5.75%, p=0.047), 201-300 (5.83%, p=0.033), or ≥ 301 (5.49%, p=0.024) patients in a year. The volume of patient discharges did not influence physician 8-30 or 30 day readmission rates.
Conclusions: Individual physician characteristics correlate with patient readmission rates. A critical level of a physician’s yearly hospital activity, as reflected by the number of patient discharges per year (>100) significantly results in lower 7-day readmission rates. Gender, post-graduate years of clinical experience, and fiscal year did not play a role. Physician hospital activity did not affect 8-30 day readmissions, suggesting that there are other physician characteristics that influence the 8-30 day readmission rate. This study suggests that there are more unidentified physician characteristics that influence the more immediate 7-day readmission rates and other characteristics that influence the longer-term 8-30 and 30 day readmission rates.