Almost 3 million Medicare patients hospitalized for heart failure (HF), heart attack, or pneumonia were readmitted to the hospital within 30 days, and a majority were readmitted within 15 days, according to a study from Columbia University Medical Center and published in JAMA.
Heart attack, or acute myocardial infarction (MI), HF and pneumonia are responsible for almost 15 percent of hospitalizations in older persons, according to the study. Researchers from Columbia University Medical Center analyzed claims data from Medicare fee-for-service beneficiaries from 2007 to 2009, looking at readmission diagnoses and timing among these patients who were readmitted within 30 days after hospitalization for these conditions.
They found the following:
- Nearly one third, or 24.8 percent of HF patients who were hospitalized were readmitted
- Nearly one fifth, or 19.9 percent of MI patients were readmitted
- Nearly one fifth or 18.3 percent of pneumonia patients were readmitted
- Following hospitalization for HF, readmissions were most often due to HF (35.2 percent),
- Following hospitalization for acute MI, readmission was most often due to HF (19.3 percent)
- Following hospitalization for pneumonia, readmission was most likely due to recurrent pneumonia (22.4 percent).
Of all 30-day readmissions, 61 percent of the HF, 67.6 percent of the acute MI, and 62.6 percent of the pneumonia patients occurred during days 0 through 15 following discharge. More than 30 percent of 30-day readmissions occurred during days 16 through 30 for all 3 conditions, the report states.
Although a high percentage of 30-day readmissions occurred relatively soon after hospitalization, readmissions remained frequent during days 16 through 30 after discharge regardless of patient age, sex, or race, the report continues.
Hospital readmissions are common and can be a marker of poor healthcare quality and efficiency. To lower readmission rates, CMS began publicly reporting 30-day risk-standardized readmission rates for heart failure (HF), MI and pneumonia after these measures were endorsed by the National Quality Forum. These measures are part of a federal strategy to provide incentives to improve quality of care by reducing preventable readmissions.
Source: Johns Hopkins Medicine, January 23, 2013
Guide to Reducing Medicare Readmissions, Vol. II examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. It looks at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.