26% of elderly home health heart failure patients readmitted

About one-quarter of older patients with heart failure who were discharged with home health followup services were readmitted to the hospital within 30 days, according to this large-scale study of 2005 data from the Medicare Chronic Conditions Warehouse.  Of the patients who were readmitted within 30 days, 81 percent had one readmission, 16.4 percent had two readmissions, and 2.3 percent had three or more readmissions.  The average time to readmission was about two weeks.  The most important predictor of readmission was found to be the number of prior hospitalizations and dyspnea (shortness of breath).

What I like about this article: I always find patient disposition studies interesting — what happens to what percent of patients.  This study also comes from an authoritative source.

Source: Madigan, E.A., and others.  Rehospitalization in a national population of home health care patients with heart failure.  HSR. Health Services Research;47(6):2316-2338, Dec. 2012.  Click here for publisher’s website: http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2012.01416.x/abstract Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

READMISSIONS: Medicare patients 30-day and 90-day rates

This is a comparison of readmission rates between Medicare Advantage (capitated) patients and Medicare fee-for-service patients.  Data were studied for 5 states for 2006 and were derived from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project.  Patients were included in the study if it was their first readmission during the year.  Here is a univariate analysis of the two groups:

• 14.38% readmission within 30 days (Medicare fee for service)
• 13.7% readmission within 30 days (Medicare Advantage)
• 26.19% readmission within 90 days (Medicare fee for service)
• 23.84% readmission within 90 days (Medicare Advantage)

However, when risk adjustment and controlling for self-selection into the Medicare Advantage plans were factored in, the researchers (all with AHRQ) were surprised to find that “hospitalized Advantage enrollees had a noticeably higher likelihood of readmission” than the fee for service enrollees did. 

Why do I like this study?  Authoritative source.  There are some actual readmission percentages published in it.  The authors were surprised by their findings.

Source: Friedman, B., and others.  Likelihood of hospital readmission after first discharge: Medicare Advantage vs. fee-for-service patients.  Inquiry;49(3):202-213, Fall 2012.  Click here to go to the publisher’s website: http://www.inquiryjournalonline.org/doi/abs/10.5034/inquiryjrnl_49.03.01 Posted by AHA Resource Center, (312) 422-2050, rc@aha.org