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Super-utilizers for this data are defined as Medicare or Medicaid patients with four or more hospital admissions or privately insured patients with three or more hospital admissions during 2012 based on a standard cut-off rule applied to the statistical distribution specific to each payer population.

The average all-cause 30-day readmission rate was four to eight times higher for super-utilizers than for other patients. Among patients aged 1-64 years, super-utilizers accounted for more than half of all 30-day readmissions.

  • For all payers, patients with multiple chronic conditions accounted for a greater share of stays among super-utilizers than among other hospitalized patients. For example, among the privately insured, patients with two or more chronic conditions constituted 60.2 percent of all stays for super-utilizers compared with 36.4 percent for other patients.
  • Super-utilizers were more likely to be admitted for medical conditions rather than surgical or other types of conditions. For example, among the privately insured, 65.1 percent of all stays for super-utilizers were admitted for medical conditions compared with 33.3 percent for other patients.
  • Common chronic and acute conditions, such as congestive heart failure and septicemia, were among the 10 most common principal diagnoses for hospitalized super-utilizers across all payers.
  • Mental health and substance use disorders were among the top 10 principal diagnoses for super-utilizers aged 1 to 64 years regardless of payer.

Source: AHRQ

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