• Hospital medicine
• Patient-centred care
• Healthcare quality improvement

Hospital readmission rates have captured the attention of policymakers, administrators, researchers and healthcare providers over the last decade. This has been spurred in no small part by the Hospital Readmissions Reduction Program, which began in the USA in 2012 and requires the Centres for Medicare and Medicaid Services to reduce payments to acute care facilities with high rates of readmission within 30 days of discharge for selected conditions. After years of intense research to find an objective measure of preventable readmissions, it seems as imminent as the arrival of Godot. Whether preventable readmissions can be objectively defined or represent a valid patient-centred measure of quality are unclear.

While the search continues for validated and objective measures of readmission, emerging commercial software programs using administrative data to flag potentially preventable readmissions (PPRs) are marketed as a solution to labour-intensive chart review. One example is the 3M Potentially Preventable Readmissions Grouping Software, a widely used proprietary program.1 Using hospital administrative data, the program identifies readmissions with diagnoses that are ‘clinically related’ to the index admission and flags them as potentially preventable. Readmissions are risk-adjusted for case mix and severity of illness. Although the program has yet to be validated, its ease of use and promise of producing an objective measure of PPR have resulted in quick uptake by many organisations.

In their BMJ Quality and Safety publication, Borzecki et al2 aim to determine whether the 3M PPR software can accurately identify …