{"id":3035,"date":"2025-08-01T07:00:44","date_gmt":"2025-08-01T11:00:44","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=3035"},"modified":"2025-08-01T07:01:03","modified_gmt":"2025-08-01T11:01:03","slug":"plan-all-cause-readmissions-pcr","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/plan-all-cause-readmissions-pcr\/","title":{"rendered":"Plan All-Cause Readmissions (PCR)"},"content":{"rendered":"

For persons 18 years of age and older, the risk-adjusted ratio of <\/span>observed<\/span>-to-expected unplanned acute readmissions (inpatient and observation stays) for any diagnosis within <\/span>30 days<\/span> of an acute hospitalization (inpatient and observation stays).\u00a0<\/span><\/span>\u00a0<\/span><\/p>\n

Why It Matters<\/h2>\n

A \u201creadmission\u201d occurs when a patient is discharged from the hospital and then admitted back into the hospital within a short period of time. <\/span>A high rate of patient readmissions may indicate inadequate quality of care in the hospital and\/or a lack of appropriate post-discharge planning and care coordination.\u00a0<\/span><\/b>\u00a0<\/span><\/p>\n

Poor care coordination at discharge can lead to adverse events for patients and avoidable rehospitalization. Readmission to the hospital within 30 days of discharge is frequently avoidable and can lead to adverse outcomes for patients (1)<\/sup>. Any preventable hospitalization can have a negative impact on health outcomes, particularly for older adults and adults with multiple chronic conditions. Health risks associated with hospitalization include infection, adverse drug events, loss of function, isolation and negative quality of life, and readmission.<\/span>\u00a0<\/span><\/p>\n

Hospital readmissions may indicate poor care or missed opportunities to coordinate care better. Research shows that specific hospital-based initiatives to improve communication with beneficiaries and their caregivers, coordinate care after discharge and improve the quality of care during the initial admission can avert many readmissions.<\/span>\u00a0<\/span><\/p>\n

There is extensive evidence about adverse events in patients, and this measure aims to distinguish readmissions from complications of care and pre-existing comorbidities (2)<\/sup>. This measure assesses the number of acute inpatient and observation stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days for members 18 years of age and older in the following categories:\u00a0<\/span>\u00a0<\/span><\/p>\n