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Association of 30-Day All-Cause Readmission with Long-Term Outcomes in Hospitalized Older Medicare Beneficiaries with Heart Failure.
- Source :
-
American Journal of Medicine . Nov2016, Vol. 129 Issue 11, p1178-1184. 7p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Heart failure is the leading cause for 30-day all-cause readmission. We examined the impact of 30-day all-cause readmission on long-term outcomes and cost in a propensity score-matched study of hospitalized patients with heart failure.<bold>Methods: </bold>Of the 7578 Medicare beneficiaries discharged with a primary diagnosis of heart failure from 106 Alabama hospitals (1998-2001) and alive at 30 days after discharge, 1519 had a 30-day all-cause readmission. Using propensity scores for 30-day all-cause readmission, we assembled a matched cohort of 1516 pairs of patients with and without a 30-day all-cause readmission, balanced on 34 baseline characteristics (mean age 75 years, 56% women, 24% African American).<bold>Results: </bold>During 2-12 months of follow-up after discharge from index hospitalization, all-cause mortality occurred in 41% and 27% of matched patients with and without a 30-day all-cause readmission, respectively (hazard ratio 1.68; 95% confidence interval 1.48-1.90; P <.001). This harmful association of 30-day all-cause readmission with mortality persisted during an average follow-up of 3.1 (maximum, 8.7) years (hazard ratio 1.33; 95% confidence interval 1.22-1.45; P <.001). Patients with a 30-day all-cause readmission had higher cumulative all-cause readmission (mean, 6.9 vs 5.1; P <.001), a longer cumulative length of stay (mean, 51 vs 43 days; P <.001), and a higher cumulative cost (mean, $38,972 vs $34,025; P = .001) during 8.7 years of follow-up.<bold>Conclusions: </bold>Among Medicare beneficiaries hospitalized for heart failure, 30-day all-cause readmission was associated with a higher risk of subsequent all-cause mortality, higher number of cumulative all-cause readmission, longer cumulative length of stay, and higher cumulative cost. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEART failure treatment
*CHRONIC kidney failure
*CORONARY disease
*DIABETES
*HEART failure
*HOSPITAL care
*LONGITUDINAL method
*OBSTRUCTIVE lung diseases
*MEDICARE
*MORTALITY
*MULTIVARIATE analysis
*PROBABILITY theory
*PROGNOSIS
*RESEARCH funding
*COMORBIDITY
*TREATMENT effectiveness
*PROPORTIONAL hazards models
*CASE-control method
*PATIENT readmissions
Subjects
Details
- Language :
- English
- ISSN :
- 00029343
- Volume :
- 129
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- American Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 119521100
- Full Text :
- https://doi.org/10.1016/j.amjmed.2016.06.018