Becker's Clinical Quality & Infection Control

Reducing Readmissions 19 Report: U.S. Made Little Progress on Readmission Rates 2008-2010 By Sabrina Rodak  T he readmission rates in hospitals across the U.S. have not changed significantly from 2008 to 2010, according to a report from the Robert Wood Johnson Foundation based on data from the Dartmouth Atlas Project. The report, "The Revolving Door: A Report on U.S. Hospital Readmissions," includes new data from the Dartmouth Atlas Project as well as interviews conducted by PerryUndem Research & Communication with patients, caregivers and healthcare providers. The Dartmouth Atlas Project examined readmission data for Medicare beneficiaries in 306 Dartmouth Atlas hospital referral regions from 2008 to 2010. Researchers looked at five categories of readmissions: all medical discharges, all surgical discharges and discharges for acute myocardial infarction, congestive heart failure and pneumonia. The researchers made several important findings. First, the rate of readmissions has not improved significantly from 2008 to 2010 in most regions and hospitals. Only six of 92 academic medical centers studied had statistically significant changes in 30-day readmission rates for medical discharges, and only seven academic medical centers had statistically significant changes in 30-day readmission rates after surgery; in both groups, at least one hospital's readmission rates increased. Secondly, readmission rates vary widely across geographic regions. For example, the readmission rate following medical discharges in 2010 ranged from a low of 11.4 percent in Ogden, Utah, to 18.1 percent in Bronx, N.Y. Similarly, for surgery discharges, the 30-day readmission rate varied from 7.6 percent in Bend, Ore., to 18.3 percent in Bronx, N.Y. n Study: Income Inequality Linked to Higher Readmissions Avoidable Readmissions by Numbers: 8 Statistics By Sabrina Rodak   By Molly Gamble U .S. states with the highest income inequality have an estimated 40,000 extra readmissions than states with the lowest income inequality, according to a study in the British Medical Journal. Researchers examined the association between income inequality, measured by the Gini coefficient, and the risk of mortality and readmission within 30 days post-hospital admission and discharge, respectively. Researchers studied Medicare patients in the U.S. hospitalized in 2006 to 2008 with a principal diagnosis of acute myocardial infarction, heart failure or pneumonia. The risk of readmission for all three diagnoses was greater in states in the three highest quarters of income inequality compared with states in the lowest quarter. The authors estimated that from 2006 through 2008, there were an additional 7,153 readmissions for acute myocardial infarction; 17,991 readmissions for heart failure; and 14,127 readmissions for pneumonia associated with income inequality in states in the three highest quarters of income equality compared with states in the lowest quarter. However, the risk of mortality within 30 days of hospital admission did not differ between states based on income inequality. n P otentially avoidable readmissions make up 10 percent to 14 percent of all admissions for most hospitals, or roughly 45 percent of them, according to Objective Health. Here are seven more statistics on the associated costs of avoidable hospital readmissions. 1. Based on 220 hospitals in 2011, the average avoidable readmission rate in the United States was 12.6 percent. 2. Potentially avoidable readmissions equated to $9.5 million in annual atrisk profit for an average 300-based hospital in 2011. 3. The most common conditions for avoidable readmissions are: • Congestive Heart Failure (30 percent) • Bacterial Pneumonia (24 percent) • COPD or Asthma in Older Adults (13 percent) • Urinary Tract Infection (10 percent) and • Diabetes with Short-term Complications (9 percent). n Becker's Clinical Quality & Infection Control E-Weekly Sign up today for the complimentary twice-weekly newsletter featuring the most current news, analysis and best practices on operating room clinical quality, safety, infection control and accreditation. To sign up, visit: www.beckersasc.com/clinicalquality

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