Factors that Impact Readmission for Medicare and Medicaid HMO Inpatients

Abstract

Background: Hospital readmission is an outcome associated with failure of treatment because readmitted patients are still sick despite recent inpatient treatment. The specific 30-day period is critical because the U.S. Government's Centers for Medicare and Medicaid Services uses a 30-day period for measuring treatment quality and reimbursement for many conditions. Objective: The purpose of this study was to identify demographic factors associated with 30-day readmission for patients initially admitted with any of the following conditions; Congestive Heart Disease (CHF), Pneumonia (PN), and Chronic Obstructive Pulmonary Disease (COPD). Methods: This retrospective study analyzed factors that were associated with readmission. Descriptive statistics and bivariate analysis were used to assess the impact on readmission for the following variables: age, sex, length of stay (LOS), payer, admitting location, initial and secondary diagnosis, and initial discharge location. Results: The results demonstrated that the following variables were statistically associated with readmission were: LOS (p=.008), gender (p=.019), admitting location (p=.002), initial diagnosis (p < .001), secondary diagnosis (p < .001), and discharge location (p < .001). CHF patients were specifically more likely to be readmitted compared to patients without CHF (p < .001). Conclusion: This study suggests that patient demographics, LOS, diagnosis and location may increase readmission risk. CHF patients specifically have higher readmission than other patients. Further research should examine additional factors that may contribute to higher readmission for CHF patients.