Generally, high level of readmission is associated with poor patient care, hence its relation to the quality of care is plausible.
Frequent patient readmissions have personal, financial and organisational consequences. This has motivated healthcare commissioners
in England to use emergency readmission as an indicator in the performance rating framework. A statistical model, known as
the multilevel transition model was previously developed, where individual hospitals propensity for first readmission, second
readmission, third (and so on) were considered to be measures of performance. Using these measures, we defined a new performance
index. During the period 1997 and 2004, the national (England) hospital episodes statistics dataset comprise more than 5 million
patient readmissions. Implementing a statistical model using the complete population dataset could possibly take weeks to
estimate the parameters. Moreover, it is not statistically sound to utilise the full population dataset. To resolve the problem,
we extract 1000 random samples from the original data, where each random sample is likely to lead to differing hospital performance
measures. For computational efficiency a Grid implementation of the model is developed. Using a stand-alone computer, it would
take approximately 500 hours to estimate 1000 samples, whereas in the Grid implementation, the full 1000 samples were analysed
in less than 24 hours. Analysing the output from the full 1000 sample, we noticed that 4 out of the 5 worst performing hospitals
treating cancer patients were in London.
Keywords emergency readmissions - Grid - multilevel modelling - hospital performance