Background Reducing rates of rehospitalization has attractedattention from policymakers as a way to improve quality of careand reduce costs. However, we have limited information on thefrequency and patterns of rehospitalization in the United Statesto aid in planning the necessary changes.
Methods We analyzed Medicare claims data from 2003–2004to describe the patterns of rehospitalization and the relationof rehospitalization to demographic characteristics of the patientsand to characteristics of the hospitals.
Results Almost one fifth (19.6%) of the 11,855,702 Medicarebeneficiaries who had been discharged from a hospital were rehospitalizedwithin 30 days, and 34.0% were rehospitalized within 90 days;67.1% of patients who had been discharged with medical conditionsand 51.5% of those who had been discharged after surgical procedureswere rehospitalized or died within the first year after discharge.In the case of 50.2% of the patients who were rehospitalizedwithin 30 days after a medical discharge to the community, therewas no bill for a visit to a physician's office between thetime of discharge and rehospitalization. Among patients whowere rehospitalized within 30 days after a surgical discharge,70.5% were rehospitalized for a medical condition. We estimatethat about 10% of rehospitalizations were likely to have beenplanned. The average stay of rehospitalized patients was 0.6day longer than that of patients in the same diagnosis-relatedgroup whose most recent hospitalization had been at least 6months previously. We estimate that the cost to Medicare ofunplanned rehospitalizations in 2004 was $17.4 billion.
Conclusions Rehospitalizations among Medicare beneficiariesare prevalent and costly.
Source Information
From an independent consulting practice, Baltimore (S.F.J.); the Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.V.W.); and the Care Transitions Program, Division of Health Care Policy and Research, University of Colorado at Denver, Denver (E.A.C.).
Wolinsky, F. D., Bentler, S. E., Liu, L., Jones, M. P., Kaskie, B., Hockenberry, J., Chrischilles, E. A., Wright, K. B., Geweke, J. F., Obrizan, M., Ohsfeldt, R. L., Rosenthal, G. E., Wallace, R. B.
(2010). Prior Hospitalization and the Risk of Heart Attack in Older Adults: A 12-Year Prospective Study of Medicare Beneficiaries. J Gerontol A Biol Sci Med Sci
: glq003v1-glq003
[Abstract][Full Text]
Topol, E. J.
(2010). Transforming Medicine via Digital Innovation. Sci Transl Med
2: 16cm4-16cm4
[Full Text]
Bhalla, R., Kalkut, G.
(2010). Could Medicare Readmission Policy Exacerbate Health Care System Inequity?. ANN INTERN MED
152: 114-117
[Abstract][Full Text]
Sheeran, T., Byers, A. L., Bruce, M. L.
(2010). Depression and Increased Short-Term Hospitalization Risk Among Geriatric Patients Receiving Home Health Care Services. Psychiatr. Serv.
61: 78-80
[Abstract][Full Text]
Sosa, J. A.
(2010). A Cautionary Note Regarding Safety of Thyroidectomy in the Elderly. Arch Surg
145: 9-10
[Full Text]
Ross, J. S., Chen, J., Lin, Z., Bueno, H., Curtis, J. P., Keenan, P. S., Normand, S.-L. T., Schreiner, G., Spertus, J. A., Vidan, M. T., Wang, Y., Wang, Y., Krumholz, H. M.
(2010). Recent National Trends in Readmission Rates After Heart Failure Hospitalization. Circ Heart Fail
3: 97-103
[Abstract][Full Text]
Jha, A. K., Orav, E. J., Epstein, A. M.
(2009). Public Reporting of Discharge Planning and Rates of Readmissions. NEJM
361: 2637-2645
[Abstract][Full Text]
Nyweide, D. J., Weeks, W. B., Gottlieb, D. J., Casalino, L. P., Fisher, E. S.
(2009). Relationship of Primary Care Physicians' Patient Caseload With Measurement of Quality and Cost Performance. JAMA
302: 2444-2450
[Abstract][Full Text]
Chawla, S., Pastores, S. M., Hassan, K., Raoof, N. D., Voigt, L. P., Alicea, M., Halpern, N. A.
(2009). ICU Admissions After Actual or Planned Hospital Discharge: Incidence, Clinical Characteristics, and Outcomes in Patients With Cancer. Chest
136: 1257-1262
[Abstract][Full Text]
Dunlay, S. M., Redfield, M. M., Weston, S. A., Therneau, T. M., Hall Long, K., Shah, N. D., Roger, V. L.
(2009). Hospitalizations after heart failure diagnosis a community perspective.. J Am Coll Cardiol
54: 1695-1702
[Abstract][Full Text]
Setoguchi, S., Stevenson, L. W.
(2009). Hospitalizations in patients with heart failure: who and why.. J Am Coll Cardiol
54: 1703-1705
[Full Text]
Kao, H., Walter, L. C.
(2009). Improvement of Hospital Care of Elderly Patients: Thinking Outside the (Hospital) Box: Comment on "Hospital at Home for Elderly Patients With Acute Decompensation of Chronic Heart Failure". Arch Intern Med
169: 1576-1577
[Full Text]
Kereiakes, D. J.
(2009). Return to sender hospital readmission after percutaneous coronary intervention.. J Am Coll Cardiol
54: 908-910
[Full Text]
Anderson, G.
(2009). The effects of payment by results. BMJ
339: b3081-b3081
[Full Text]
Kinkade, S.
(2009). An exercise and telephone follow-up programme reduced emergency readmissions and improved quality of life in older people. Evid. Based Med.
14: 120-120
[Full Text]
Van Way, C. W. III
(2009). Change Is in the Wind. Nutr Clin Pract
24: 433-435
[Full Text]
Naylor, M. D., Kurtzman, E. T., Pauly, M. V.
(2009). Transitions of Elders Between Long-Term Care and Hospitals. Policy Politics Nursing Practice
10: 187-194
[Abstract]
Rackow, E. C., Straube, B. M., McGann, P. E., Rapp, M. T., Rohr, R., Jencks, S. F., Williams, M. V., Coleman, E. A.
(2009). Rehospitalizations among Patients in the Medicare Fee-for-Service Program. NEJM
361: 311-312
[Full Text]
Clancy, C. M.
(2009). Reengineering Hospital Discharge: A Protocol to Improve Patient Safety, Reduce Costs, and Boost Patient Satisfaction. American Journal of Medical Quality
24: 344-346
Epstein, A. M.
(2009). Revisiting Readmissions -- Changing the Incentives for Shared Accountability. NEJM
360: 1457-1459
[Full Text]
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