Abstract：Objective To calculate the rank reliability of readmission rates for acute myocardial infarction (AMI), and to explore whether the readmission rates can be used as reliable indicators for evaluating doctors' treatment quality so as to provide a reference basis for supervision on treatment quality of AMI. Methods Medical records of AMI patients treated by doctors in a hospital were collected. Two-level mixed-effects model was used to estimate the impact of patient characteristics and random variations on the ranking of doctors' treatment quality, and the reliability of readmission rates for AMI for ranking doctors' treatment quality was calculated. Results The data about medical records of 4,645 patients treated by 29 doctors were enrolled in this study, and 459 patients were readmitted, with a readmission rate of 9.88% in this hospital. The median number of AMI patients treated by doctors was 151 (IQR: 93-232), and the median of readmission rate based on doctors' therapeutic level was 7.20% (5.52%-11.48%). There werestatistically significant differences in patients' age, gender, smoking, family history, route of admission and complications between the readmission group and the non-readmission group (P<0.5). The proportions of patients' average age, female patients, patients with a family history of myocardial infarction, inpatients admitted from the emergency department, patients with cardiac function failure and patients with pulmonary circulation dysfunction in the readmission group were all higher than those in the non-readmission group. The rank reliability of readmission rates for AIM was 41.6%. Variations in the readmission rates revealed that 41.6% variations were due to doctors' treatment quality, 54.2% due to random variations, and 4.2% due to patient characteristics.Conclusion Random variations and patient characteristics have impacts on the accuracy of estimation of readmission rates for AIM, and the rank reliability of readmission rates for AMI is low. And hence, hospital managers should be cautious of ranking doctors' treatment quality by using readmission rates for AMI.
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