The Re-admission Dilemma

Hospital readmission rates linked to greater patient needs

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Certain regions of the U.S. suffer from high hospital readmission rates. Interestingly, that elevated number may have less to do with poor care or more severe illnesses.

The actual reason for higher hospital readmission in some parts of the country may simply be a greater overall use of hospital services.

"Seek appropriate follow up care to lower your chance of rehospitalization."

Arnold Epstein, lead author of the study, John H. Foster Professor of Health Policy and Management and chair of the department of health policy and management at Harvard School of Public Health, said that the largely unrecognized observation is important, especially since hospitals may have limited ability to reduce readmissions.

He noted that the responsibility for readmissions lies with the entire delivery system, and that incentives may be needed to prompt a change in culture.

During the study researchers used national Medicare data from the first six months of 2008 to calculate the 30-day, 60-day and 90-day readmission rates among patients hospitalized for congestive heart failure or pneumonia. The statistics were calculated for different regions in the U.S.

Investigators reviewed overall hospitalization rates, the number of doctors and hospital beds in each region, the quality of discharge planning and other medical conditions readmitted patients may have had.

Among congestive heart failure patients, the readmission rates ranged between 11 percent and 32 percent, while 8 percent to 27 percent of those with pneumonia were readmitted.

A greater severity of other conditions was found to be linked to higher regional readmission rates. Yet overall hospital admission rates played the largest role. Hospital admission rates accounted for 16 percent to 24 percent among congestive heart failure patients, and 11 percent to 20 percent among pneumonia cases. No other factor was attributed to more than 6 percent of the increase.

Reducing readmission is key because it is expensive and can lead to poor outcomes for patients. Researchers suggest that the way to reduce readmission rates may be sharing savings with health care providers that can aid in reducing readmission.

The study was published in the Dec. 15 issue of the New England Journal of Medicine.

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Review Date: 
December 15, 2011
Last Updated:
December 17, 2011