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30-Day Readmission Rates After Hospitalization: Diagnoses and Timing

Article: Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA. 2013;309(4):355-363.

Summary

Study examines reasons for and timing of readmissions for older patients following heart attack, heart failure and pneumonia.

Abstract

Importance To better guide strategies intended to reduce high rates of 30‑day readmission after hospitalization for heart failure (HF), acute myocardial infarction (MI), or pneumonia, further information is needed about readmission diagnoses, readmission timing, and the relationship of both to patient age, sex, and race.

Objective To examine readmission diagnoses and timing among Medicare beneficiaries readmitted within 30 days after hospitalization for HF, acute MI, or pneumonia.

Design, Setting, and Patients We analyzed 2007‑2009 Medicare fee‑for‑service claims data to identify patterns of 30‑day readmission by patient demographic characteristics and time after hospitalization for HF, acute MI, or pneumonia. Readmission diagnoses were categorized using an aggregated version of the Centers for Medicare & Medicaid Services' Condition Categories. Readmission timing was determined by day after discharge.

Main Outcome Measures We examined the percentage of 30‑day readmissions occurring on each day (0‑30) after discharge; the most common readmission diagnoses occurring during cumulative periods (days 0‑3, 0‑7, 0‑15, and 0‑30) and consecutive periods (days 0‑3, 4‑7, 8‑15, and 16‑30) after hospitalization; median time to readmission for common readmission diagnoses; and the relationship between patient demographic characteristics and readmission diagnoses and timing.

Results From 2007 through 2009, we identified 329 308 30‑day readmissions after 1 330 157 HF hospitalizations (24.8% readmitted), 108 992 30‑day readmissions after 548 834 acute MI hospitalizations (19.9% readmitted), and 214 239 30‑day readmissions after 1 168 624 pneumonia hospitalizations (18.3% readmitted). The proportion of patients readmitted for the same condition was 35.2% after the index HF hospitalization, 10.0% after the index acute MI hospitalization, and 22.4% after the index pneumonia hospitalization. Of all readmissions within 30 days of hospitalization, the majority occurred within 15 days of hospitalization: 61.0%, HF cohort; 67.6%, acute MI cohort; and 62.6%, pneumonia cohort. The diverse spectrum of readmission diagnoses was largely similar in both cumulative and consecutive periods after discharge. Median time to 30‑day readmission was 12 days for patients initially hospitalized for HF, 10 days for patients initially hospitalized for acute MI, and 12 days for patients initially hospitalized for pneumonia and was comparable across common readmission diagnoses. Neither readmission diagnoses nor timing substantively varied by age, sex, or race.

Conclusion and Relevance Among Medicare fee‑for‑service beneficiaries hospitalized for HF, acute MI, or pneumonia, 30‑day readmissions were frequent throughout the month after hospitalization and resulted from a similar spectrum of readmission diagnoses regardless of age, sex, race, or time after discharge.


Interview with Harlan M. Krumholz, MD, SM, author of Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

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Tasas de reingreso al cabo de 30 días tras la hospitalización: diagnósticos y plazos

Artículo: Diagnósticos y plazos de los reingresos a 30 días tras hospitalización por insuficiencia cardíaca, infarto agudo de miocardio o neumonía. JAMA. 2013;309(4):355-363.

Summary

En el estudio se examinan los motivos y los plazos de reingreso de pacientes de edad avanzada tras sufrir un infarto de miocardio, insuficiencia cardíaca y neumonía.

Entrevista con Harlan M. Krumholz, MD, SM, autor de Diagnósticos y plazos de los reingresos a 30 días tras hospitalización por insuficiencia cardíaca, infarto agudo de miocardio o neumonía.

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Taux de réhospitalisation à 30 jours après hospitalisation : diagnostics et délai précédant la réhospitalisation

Article: Diagnostics et délais précédant une réhospitalisation à 30 jours après une hospitalisation pour insuffisance cardiaque, infarctus aigu du myocarde ou pneumonie. JAMA. 2013;309(4):355-363.

Summary

Une étude examine les causes à l'origine de la réhospitalisation de patients âgés, auparavant hospitalisés en raison d'une crise cardiaque, d'une insuffisance cardiaque ou d'une pneumonie, et le délai précédant ces réhospitalisations.

Entretien avec Harlan M. Krumholz, MD, SM, auteur de Diagnostics et délais précédant une réhospitalisation à 30 jours après une hospitalisation pour insuffisance cardiaque, infarctus aigu du myocarde ou pneumonie.

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Tassi di nuovo ricovero entro 30 giorni dal ricovero iniziale: diagnosi e tempistiche

Articolo: Diagnosi e tempistica di un nuovo ricovero a 30 giorni dai primo ricovero per scompenso cardiaco, infarto miocardico acuto e polmonite. JAMA. 2013;309(4):355-363.

Summary

Lo studio esamina i motivi e i tempi dei nuovi ricoveri per i pazienti più anziani dopo un evento di infarto, scompenso cardiaco e polmonite.

Intervista a Harlan M. Krumholz, MD, SM, autore di Diagnosi e tempistica di un nuovo ricovero a 30 giorni dai primo ricovero per scompenso cardiaco, infarto miocardico acuto e polmonite.

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住院后 30 天再入院率:诊断和时间

文章: 心力衰竭、急性心肌梗死或肺炎患者住院后30天再入院的诊断和时间。 JAMA. 2013;309(4):355-363.

Summary

研究探讨老年患者因心脏病发作、心力衰竭和肺炎住院后再次入院的原因和时间。

专访 Harlan M. Krumholz, MD, SM, 作者 心力衰竭、急性心肌梗死或肺炎患者住院后30天再入院的诊断和时间。

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30-Day Readmission Rates After Hospitalization: Diagnoses and Timing

статья: Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA. 2013;309(4):355-363.

Summary

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Интервью с Harlan M. Krumholz, MD, SM автор Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

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30-Day Readmission Rates After Hospitalization: Diagnoses and Timing

Artigo: Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA. 2013;309(4):355-363.

Summary

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Entrevista com o Harlan M. Krumholz, MD, SM autor de Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

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Wiedereinlieferungsquoten innerhalb von 30 Tagen nach Krankenhausaufenthalt: Diagnosen und zeitliche Abläufe

Artikel: Diagnosen und zeitliche Abläufe bei Wiedereinlieferungen innerhalb von 30 Tagen nach Krankenhausaufenthalten aufgrund von Herzinsuffizienz, akutem Myokardinfarkt oder Lungenentzündung. JAMA. 2013;309(4):355-363.

Summary

Eine Studie untersucht, warum und wann ältere Patienten nach Herzinfarkten, Herzinsuffizienz und Lungenentzündung erneut ins Krankenhaus eingeliefert werden.

Interview mit Harlan M. Krumholz, MD, SM, autor Diagnosen und zeitliche Abläufe bei Wiedereinlieferungen innerhalb von 30 Tagen nach Krankenhausaufenthalten aufgrund von Herzinsuffizienz, akutem Myokardinfarkt oder Lungenentzündung.

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