Image of male nurse pushing senior woman in a wheelchair in nursing facility

Compared with other quality measures, pressure ulcer prevalence is particularly good at predicting whether a nursing home will readmit residents to the hospital, according to findings published recently in HSR: Health Services Research.

Skilled nursing facilities with a high percentage of high-risk, long-stay residents with pressure sores had higher hospital readmission rates, the researchers found. Measures of urinary tract infections, vaccinations and restraining residents were not found to be significant in predicting readmissions.

Investigators analyzed 4,000 hospitals’ publicly reported readmission rates associated with pneumonia, myocardial infarction and heart failure between 2007 and 2010. They ultimately determined how much impact community factors had on readmissions.

Nearly 60% of the variation in hospitals’ readmission rates can be explained by county-level factors, such as educational attainment, that are largely outside the hospitals’ control, they found. Policies that address “the wider system of care, including primary care and nursing home quality” might be more effective than hospital-only readmissions penalties, they concluded.