AHRQ Study Identifies Characteristics Associated With Hospital Readmissions

Three-quarters of patients readmitted to a hospital after being discharged return to the same hospital, according to a new AHRQ-funded study. Researchers found that patients admitted for orthopedic conditions and patients who entered the hospital through the emergency department were the most likely to have a same-hospital readmission. Regarding readmissions overall, the highest rates were found in patients aged 65 to 84, though patients aged 45 to 64 who underwent spinal fusion had similar readmission rates. The condition most commonly associated with readmission was heart failure, and the conditions for which a readmission was least likely were hip and knee arthroplasty. Women made up a larger portion of readmissions across all conditions, except for heart attack. To conduct this research, investigators used the State Inpatient Databases, a component of AHRQ’s Healthcare Cost and Utilization Project (HCUP). They analyzed data on adults discharged from hospitals in 16 states. HCUP is the nation’s most comprehensive source of hospital data, including information on inpatient care, ambulatory care, and emergency department visits. The study, “Patient Factors Contributing to Variation in Same-Hospital Readmission Rate,” and abstract were published in the March 30 issue of the journal Medical Care Research and Review.

2015 Jun;72(3):338-58. doi: 10.1177/1077558715577478. Epub 2015 Mar 30.

Patient factors contributing to variation in same-hospital readmission rate.

Henke RM1, Karaca Z2, Lin H3, Wier LM3, Marder W3, Wong HS2.

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Abstract

The Centers for Medicare & Medicaid Services Hospital Readmission Reduction Program and the Centers for Medicare & Medicaid Innovations Bundled Payments for Care Improvement Initiative hold hospitals accountable for readmissions that occur at other hospitals. A few studies have described the extent to which hospital readmissions occur at the original place of treatment (i.e., same-hospital readmissions). This study uses data from 16 states to describe variation in same-hospital readmissions by patient characteristics across multiple conditions. We found that the majority of 30-day readmissions occur at the same hospital, although rates varied considerably by condition. A significant number of hospitals had very low rates of same-hospital readmissions, meaning that the majority of their readmissions went to other hospitals. Future research should examine why some hospitals are able to retain patients for a same-hospital readmission and others are not.