Measuring Equity in Readmission as an Assessment of Hospital Performance—Reply

In Reply We agree with Drs Gallo and Santiago that research is needed to identify and target the upstream contributors to disparities in hospital readmissions. These root causes function both at the level of the hospital and outside of the hospital via the social determinants of health. In our recent study, we proposed a novel measure of equity—an important domain of health care quality that has only recently been incorporated into formal hospital accountability programs. Quality measurement, through its use in public reporting and value-based payment programs, is a known and effective policy-level intervention that drives hospital-level investment in quality. Measuring equity through quality measurement could motivate hospitals to investigate and address drivers of disparate outcomes within their own system.