Journal article
Heart failure: Same-hospital vs. different-hospital readmission outcomes
International journal of cardiology, Vol.278, pp.186-191
03/01/2019
DOI: 10.1016/j.ijcard.2018.12.043
PMID: 30579719
Abstract
Heart Failure (HF) is a major driver of the readmissions/penalties in the US. Although extensive literature on rehospitalization attributed to HF, studies to compare outcomes for same-hospital vs. different-hospital readmissions are sparse.
Nationwide Readmission Database from 2010 to 14 utilized for HF-related hospitalization using appropriate ICD-9-CM diagnostic codes. 30-day readmissions were classified into two groups: same-hospital and different-hospital. A comparative analysis was conducted focusing on: in-hospital mortality, length of stay (LOS) and hospitalization cost. Hierarchical two-level modeling and propensity score matching utilized to adjust confounders.
715,993 HF readmissions were identified, of which 21.3% were readmitted to different-hospital. Elderly, females, patients with higher co-morbidities and higher median household income were less likely to be readmitted to different-hospital. Index hospitalizations in a teaching hospital and/or larger hospital were associated with reduced different-hospital readmissions. Readmissions to the different hospital were associated with higher in-hospital mortality (7.7% vs. 6.6%, p < 0.001), higher resource utilization (LOS:7.5 days vs. 6.1 days, p < 0.001 and Cost: $22,602 vs. $13,740, p < 0.001) after adjusting for propensity score match. Similar results were observed with propensity score matching of multiple high-risk subgroups.
Resources should be directed towards minimizing different-hospital HF readmissions to improve patient outcomes by identifying the vulnerable subgroup and further tailoring in-hospital and post-discharge care.
•Heart failure outcomes for same vs. different hospital readmission are seldom studied.•Higher household income, elderly, females less likely readmitted to different-hospital.•Readmissions to the different hospital were associated with higher in-hospital mortality.•Different hospital readmissions were associated with higher resource utilization.
Details
- Title: Subtitle
- Heart failure: Same-hospital vs. different-hospital readmission outcomes
- Creators
- Sopan Lahewala - Department of Medicine, Robert Wood Johnson – Barnabas Health, Jersey City, NJ, United States of AmericaShilpkumar Arora - Department of Cardiology, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, United States of AmericaByomesh Tripathi - Department of Cardiology, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, United States of AmericaSidakpal Panaich - Department of Interventional Cardiology/Structural Heart Disease, University of Iowa, United States of AmericaVarun Kumar - Department of Cardiology, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, United States of AmericaNirali Patel - Department of Cardiology, University of Southern California, California, LA, United States of AmericaSejal Savani - Department of Cardiology, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, United States of AmericaMihir Dave - Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of AmericaYash Varma - Department of Medicine, Guthrie Hospital, Sayre, PA, United States of AmericaApurva Badheka - Department of Cardiology, The Everett Clinic, Everett, WA, United States of AmericaAbhishek Deshmukh - Department of Cardiology, Mayo Clinic, Rochester, MN, United States of AmericaUmesh Gidwani - Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of AmericaRadha Gopalan - Department of Cardiology, University of Arizona College of Medicine, Phoenix, AZ, United States of AmericaAlexandros Briasoulis - Department of Interventional Cardiology/Structural Heart Disease, University of Iowa, United States of America
- Resource Type
- Journal article
- Publication Details
- International journal of cardiology, Vol.278, pp.186-191
- DOI
- 10.1016/j.ijcard.2018.12.043
- PMID
- 30579719
- NLM abbreviation
- Int J Cardiol
- ISSN
- 0167-5273
- eISSN
- 1874-1754
- Publisher
- Elsevier B.V
- Language
- English
- Date published
- 03/01/2019
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094335002771
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