High Probability of Readmission After Hospitalization

Date: Jan-23-2013An estimated 2 in every 10 people who are hospitalized have to receive acute care 30 days following discharge, with close to 40 percent of such cases resulting in emergency department visits. This finding comes from a recent study published in the latest issue of JAMA.

According to the background information in the article, the readmissions are often related to the first hospitalization and can be extremely costly.

The authors added:

 
"Current efforts to improve health care focus on hospital readmission rates as a marker of quality and on the effectiveness of transitions in care during the period after acute care is received. Emergency department (ED) visits are also a marker of hospital based acute care following discharge but little is known about ED use during this period."

The purpose of the study was to identify the extent of acute care service among patients 30 days after being discharged, in particular the number of ED visits and readmissions that occurred. The researchers monitored patients between July 2008 and September 2009 in California, Nebraska and Florida using information from the Healthcare Cost and Utilization Project state inpatient and ED databases.

They analyzed 5,032,254 index hospitalizations in 4,028,555 patients. 48 percent of the patients were Caucasian and a little over half were women (53.5 percent). 17.9% of the hospitalization cases were found to result in the need for acute care within 30 days of discharge, with 7.5% of discharges resulting in an ED encounter and 12.3 percent resulting in a readmission. ED visits made up close to 40% of the acute care encounters.

There were over 470 different index discharge conditions found, ranging from breast malignancy to benign prostatic hypertrophy.

The authors said:

"In conclusion, hospital-based acute care encounters are frequent among patients recently discharged from an inpatient setting. An improved understanding of how the ED setting is best used in the management of acute care needs - particularly for patients recently discharged from the hospital - is an important component of the effort to improve care transitions. The use of hospital readmissions as a lone metric for postdischarge health care quality may be incomplete without considering the role of the ED."

They added:

"Just as the Patient Protection and Affordable Care Act requires the development of programs to reduce readmissions, further initiatives are necessary to understand the drivers of postdischarge ED use and the clinical and financial efficiency associated with providing such acute care in the ED."

Written by Joseph Nordqvist

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today
Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.