Hospital readmissions cost hospitals about $26 billion annually. Systems like the Hospital Readmission Reduction Program (HRRP) within the Affordable Care Act penalize hospitals with higher readmission rates for targeted diagnoses. Health care data reveal that health care facilities located in rural Southern Appalachia show readmission rates that are above the national average, which results in penalties to hospitals within this region. In order to assess and prevent the causes of these frequent hospital readmission, researchers performed a retrospective review of rural Southern Appalachia.
Researchers reviewed 15,500 patients admitted to rural Southern Appalachia hospitals from Jan. 1, 2014, to Oct. 31, 2017. In order to determine associations with readmission, univariate analyses and regression modeling were conducted on potential associated variables such as length of stay; age; gender; health care payer; discharge month/day/time; tobacco use; smoking cessation education; medication reconciliation upon discharge; and presence of comorbid diagnoses like diabetes mellitus, hypertension chronic renal failure and psychiatric disorders.
The authors found that every day spent in the hospital, readmission likelihood increases by 2.9 percent. Individuals discharged between 0100-1300 were less likely to be readmitted compared with those discharged between 1300-0100 (P<.0001). Former smokers were more likely than never smokers to be readmitted and if patients were provided with smoking cessation education at discharge decreased the likelihood of readmission. The discharge month analysis indicated a significant effect only for those discharged in March and August compared with January. Research also revealed that patients with a diagnosis of COPD, diabetes mellitus, hypertension, psychiatric disorders and chronic renal failure had an increased likelihood of readmission as well.
"Primary causes of hospital readmissions in rural Southern Appalachia are increased length of stay, discharges after 1300, history of smoking and presence of comorbid COPD, diabetes mellitus, hypertension, chronic renal failure and psychiatric disorders," says Dr. Christine A. Moore, lead researcher. "Some methods to prevent readmissions are decreasing length of stay, discharging patients before 1300, providing smoking cessation education and controlling comorbid diagnoses."
Further results from these two studies will be shared at CHEST Annual Meeting 2018 in San Antonio on Monday, Oct. 8, 5:00 p.m. to 5:15 p.m., at the Henry B. Gonzalez Convention Centre, Room 206B. The study abstracts can be viewed on the journal CHEST® website.
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ABOUT CHEST 2018
CHEST 2018 is the 84th annual meeting for the American College of Chest Physicians held Oct. 6 to Oct. 10, 2018, in San Antonio, Texas. The American College of Chest Physicians, publisher of the journal CHEST®, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research and team-based care. Its mission is to champion the prevention, diagnosis and treatment of chest diseases through education, communication and research. It serves as an essential connection to clinical knowledge and resources for its 19,000 members from around the world who provide patient care in pulmonary, critical care and sleep medicine. For more information about CHEST 2018, visit chestmeeting.chestnet.org, or follow CHEST meeting hashtag, #CHEST2018, on social media.