African Americans face greater risk of hospital readmission

Hospitalized patients who are African American and/or on Medicaid face a greater chance of being readmitted to a hospital within one month of their first discharge, according to a new study published in the October issue of the Journal of Hospital Medicine. The risk of readmission also went up among patients on high-risk medications and those who were dealing with congestive heart failure, renal disease, cancer, weight loss and iron deficiency anemia.

African Americans are 43 percent more likely to be readmitted after other variables are adjusted. People on Medicaid are 15 percent more likely to be readmitted.

"Many healthcare systems are now making efforts to improve the transition from hospital to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact," Dr. Nazima Allaudeen, lead author of the study, noted in a press release. "Studies like ours should give practitioners direction to non-clinical factors to identify."

Among Medicare recipients, one in five is readmitted within 30 days at a cost of $15 billion. Identifying factors associated with increased risk for readmissions may help hospitals focus their resources to optimize the discharge process and cut avoidable readmissions and by extension, healthcare expenses.

The study findings come from an analysis of readmission statistics for 6,805 unique patients who were seen 10,359 times at University of California San Francisco hospitals. Nearly half of the readmissions took place within 10 days of the initial stay. One-quarter of readmissions had the same primary diagnosis upon repeat admission.

Poor nutritional status and mood are other factors associated with higher readmission rates, according to a much smaller study also published in the same journal. Researchers looked at the risk factor profiles of 142 patients with multiple recent readmissions and found that chronic disease diagnosis the strongest predictor of patient readmission, with other factors including body mass index and mood.

To learn more:
- read the press release from the publisher of the Journal of Hospital Medicine
- here is the JHM article on readmission risk factors
- here is the JHM article on recurrent readmissions

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