Trends in and predictors of multiple readmissions following heart failure hospitalization: A National wide analysis from the United States

被引:2
|
作者
Thandra, Abhishek [1 ,5 ]
Balakrishna, Akshay Machanahalli [2 ]
Walters, Ryan W. [3 ]
Alugubelli, Navya [1 ]
Koripalli, Venkata Sandeep [4 ]
Alla, Venkata M. [1 ]
机构
[1] Creighton Univ, Dept Med, Div Cardiovasc Dis, Sch Med, Omaha, NE USA
[2] Creighton Univ, Sch Med, Dept Med, Omaha, NE USA
[3] Creighton Univ, Sch Med, Dept Med, Div Clin Res & Evaluat Sci, Omaha, NE USA
[4] Christus Good Shepherd Med Ctr, Dept Med, Longview, TX USA
[5] Creighton Univ, Sch Med, Dept Med, Divi s Cardiovasc Dis, 7500 Mercy Rd Suite 301, Omaha, NE 68124 USA
来源
AMERICAN JOURNAL OF THE MEDICAL SCIENCES | 2023年 / 365卷 / 02期
关键词
Heart failure; Readmissions; Trends; And predictors; ACUTE MYOCARDIAL-INFARCTION; 30-DAY READMISSION; REDUCTION PROGRAM; LAST YEAR; MORTALITY; CARE; INTERVENTION; RISK; ASSOCIATION; OUTCOMES;
D O I
10.1016/j.amjms.2022.09.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Readmission following Heart failure (HF) hospitalization is common: 25% are readmitted within a month of dis-charge and X50% within 6 months. A small proportion of these patients can have multiple readmissions within this period, adding disproportionately to the health care costs. In this study, we assessed the trends, predictors and costs associated with multiple readmissions using National readmissions database (NRD).Methods: We queried NRD for HF hospitalizations from 2010 to 2018 using ICD-9/10-CM codes. Multinomial logistic regression was used to compare readmission cohorts, with the multivariable model adjusting for other factors. All analyses accounted for the NRD sampling design were conducted using SAS v. 9.4 with p < 0.05 used to indicate statistical significance.Results: Within the study period, an estimated 6,763,201 HF hospitalizations were identified. Of these, 58% had no readmis-sion; 26% had 1 readmission; and 16% had >= 2 readmissions within 90 days of index hospitalization. There was no statistically significant change in readmission rates during the observation period. Multiple readmissions which accounted for 37% of all readmissions contributed to 57% of readmission costs. Younger age was identified as a predictor of multiple readmissions while sex, comorbidities and the type of insurance were not significantly different from those with single readmission.Conclusions: Multiple readmissions in HF are common (16%), have remained unchanged between 2010 and 2018 and impose a significant health care cost burden. Future research should focus on identifying these patients for targeted interven-tion that may minimize excessive readmissions particularly in those patients who are in the palliation phase of HF.
引用
收藏
页码:145 / 151
页数:7
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