Discharge Instructions

Avoiding hospital readmissions is incentivized as an opportunity for hospitals to decrease costs and improve health outcomes and patient satisfaction (CMS, 2020). Approximately 17% of elderly patients discharged from the hospital are readmitted within 30 days and many of these readmissions are avoidable (Bailey et al, 2019). The U.S. government started penalizing hospitals in 2012 for avoidable readmissions (Centers for Medicare & Medicaid Services, n.d.). There is a growing emphasis on providing patients with discharge instructions and follow-up care to improve health outcomes (Bennett & Probst, 2016). Disparities between and among hospitals continue around this quality measure.

Analyzing the Data

The purpose of this analysis is to compare the rates of patients who reported that they were given information about what to do during their recovery at home given the rates of readmissions and mortality for acute myocardial infarction, coronary artery bypass grafting (CABG), chronic obstructive pulmonary disease (COPD), stroke, heart failure, pneumonia, and hip/knee replacement at multiple levels, including state, county, and hospital type.

This scenario includes dynamic filtering to evaluate the rate of readmission and death by the rate of reported discharge instruction. The tool uses a diverging color scale to define the average discharge instruction rate (0-100%) by county-level on the U.S. national map. Comparisons between the type of hospital and outcome group can be viewed by hovering over regions of interest.

This data is also available in a text-based table format. This alternate format also provides hospital-specific data.

Tutorial: Using the Data

Data Sources

Hospital Compare - Patient Surveys - HCAHPS (data released July, 2020)

Hospital Compare - Unplanned Hospital Visits (data released July, 2020)

Hospital Compare - Complications and Deaths (data released July, 2020)

Hospital Compare - Hospital General Information (data released July, 2020)

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviated name of the state where the hospital is located.

County: The name of the county where the hospital is located. County names are listed as provided on the U.S. Census Bureau's list of 2019 FIPS Codes for Counties and County Equivalent Entities.

Hospital: The name of the hospital.

Patient Given Information about Recovery: The calculated rate of patients that reported on the HCAHPS patient surveys that they did receive information about what to do during their recovery at home. A higher score is desired as this indicates a high proportion of patients that were provided with information. The reporting period for this measure is July 1, 2018 through June 30, 2019.

Health Outcome Measure: The name of the major complications and death measures. The measures include mortality and readmission rates for acute myocardial infarction, coronary artery bypass grafting, chronic obstructive pulmonary disease (COPD), stroke, heart failure, pneumonia, and hip/knee replacement.

Health Outcome Rate: The calculated rates for the major complications and death measures. A lower measure is desired as this indicates a lower proportion of mortality or readmissions. The reporting period for these measures is July 1, 2015 through June 30, 2018.

Hospital Type: The type of hospital, which includes acute care hospitals and critical access hospitals (CAHs).

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.