30-day readmission frequent for heart failure and MI

In the United States, 30-day risk standardised readmission rates for heart failure (HF), acute myocardial infarction (MI), and pneumonia are now publicly reported. In order to better facilitate interventions targetted at reducing readmission rates, Dharmarajan et al. investigated readmission diagnoses and timings among Medicare beneficiaries readmitted within 30 days after hospitalisation for HF, MI, or pneumonia.

Medicare fee-for-service claims between 2007 and 2009 were analysed to identify patterns of 30-day readmission by patient demographic characteristics and time after hospitalisation for HF, acute MI, or pneumonia. The authors examined the percentage of 30-day readmissions occurring on each day (0-30) after discharge, and the most common readmission diagnoses. The relationship between patient demographic characteristics and readmission diagnoses and timing was also investigated.

The authors identified 329,308 readmissions within thirty days from a total of 1,330 557 HF hospitalisations (24.8%), 108,992 readmissions from 548,834 MI hospitalisations (19.9%), and 214,239 readmissions from 1,168 624 pneumonia hospitalisations (18.3%). 35.2% of HF patients were admitted for the same condition, compared to 10.0% of MI cases, and 22.4% of pneumonia cases; the majority of readmissions for each condition were within 15 days of hospitalisation. Neither readmission diagnoses nor timing substantively varied by age, sex, or race.

Conclusions:

For patients hospitalised with heart failure, acute MI, or pneumonia, 30-day readmissions are frequent throughout the month after hospitalisation, and result from a similar spectrum of diagnoses regardless of age, sex, race, or time after discharge.

  • Dharmarajan K, Hsieh AF, Lin Z et al. Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA 2013;309:355-363.

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