TrendLens December 7, 2017: Data Defining Readmissions Prior To 30-Days

Lisa Remington

Welcome to TrendLens…trends bending the curve in home health and post-acute care. In this issue of TrendLens, we focus on readmission data at 7-days and 30-days. Is 30-days the best analysis for readmissions? Does data for specific medical conditions tell us different information about 30-day readmissions? We provide insights for you to explore your own data. 

Lisa Remington, President, Remington Health Strategy Group

Should Your Organization Be Looking At Readmissions Prior To 30-Days?

Is 30-days the right interval for your organization to be measuring readmissions? 30-day risk-standardized, all-cause, unplanned readmission rates is widely used to measure hospital penalties.

Readmission Data For All Cause 7-Day and 30-Day (2014)

  • For both 7-day and 30-day readmissions, the rate of readmission was highest among patients with Medicare, followed by patients with Medicaid, no insurance, and private insurance.
  • Among Medicaid patients who were discharged with congestive heart failure or schizophrenia at the index stay, nearly 1 in 10 stays resulted in readmission within 7 days.
  • Among patients readmitted within 30 days of an index stay for septicemia or schizophrenia, uninsured patients were more likely than patients with insurance to return within 7 days.

   In 2014, 14 percent of inpatient stays were readmitted within 30 days. More than one--third of these readmissions occurred within 7 days, reflecting a 7-day readmission rate of 5 percent.

 

Top 5 principal diagnoses with the highest 7-day and 30-day readmission rates, 2014

Principal diagnosis at the index stay

Index stays

    7-day readmissions

   30-day readmissions

Rank

Ratea

Rank

Ratea

Total inpatient stays

27,698,101

-

5.0

-

13.9

Schizophrenia and other psychotic disorders

374,097

1

9.0

2

22.9

Alcohol-related disorders

340,076

2

7.5

4

21.5

Congestive heart failure; non-hypertensive

795,709

3

7.4

1

23.2

Heart valve disorders

117,788

4

7.3

14

18.4

Hypertension with complications, secondary hypertension

223,396

5

7.2

6

20.9

a Rate per 100 index inpatient stays

Source: AHRQ

 

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