A new study appearing in Health Services Research lends support to the argument of hospital operators that patients’ odds of being readmitted within 30 days of an inpatient stay may have more to do with the type of community the patient is released into than the quality of the care provided by the hospital.

The researchers behind the study gathered information on individual counties’ demographic and socioeconomic makeup, availability of primary care, and nursing home quality measures. Then they looked at each county’s pooled 30-day risk-standardized readmission rates for heart attack, heart failure and pneumonia patients discharged between July 2007 and June 2010 to see if any of the county characteristics correlated with higher readmission rates.

What they found was that more than half (58 percent) of the national variation in hospital readmission rates could be explained by the characteristics of the county where the hospital was located. In particular, higher readmission rates were found in counties more unmarried residents, more unemployed residents, and greater numbers of Medicare recipients. Counties with lower numbers of general practitioners (a measure of access to care) and nursing homes per capita also had higher readmission rates, while counties that were largely made up of retirement communities had lower readmission rates.

The findings are based on data from 4,073 hospitals that span 2,254 counties and underscore the need for hospitals to become involved in community-based readmission reduction strategies, if they are to be judged on their rates of readmission.