Readmissions and Mortality–Any Difference by Race?

Since the introduction of Hospital Readmission Reduction Program by the CMS, there has been a significant decrease in readmissions for all targetted diseases. However, studies have raised concern that although readmissions are decreasing, there may be an increase in mortality.

A recent study showed that there is no difference in mortality between white and black patients. Authors used interrupted time-series analysis. I enjoyed statistical modelling but wonder if the within-hospital and between hosptial effects were properly accounted for. In other words, the assumption in their modeling is that both effects are the same (unlikely to be true). It is possible that the within and between effects are different and may shed a better light on what is happening at individual hospital level and what is happening across hospitals. Having said that, it is an interesting study with important implications.