Readmission rates higher with chronic conditions

Hospital readmission rates for chronic conditions are substantially higher than rehospitalizations for acute conditions, regardless of payer or age group, the Agency for Healthcare Research and Quality (AHRQ) announced yesterday. For example, conditions such as congestive heart failure or diabetes had higher incidences of patients bouncing back to the hospital than for an acute cases like pneumonia or heart attack.

"Readmission rates were consistently higher for non-surgical hospitalizations," the report states.

In 2008, one in five nonsurgical cases had a 30-day readmission, compared to one in eight surgical cases.

According to AHRQ's latest numbers, readmission rates for nonsurgical hospitalizations for chronic conditions was 23 percent, compared to 19 percent for acute conditions in elderly Medicare patients (over 65). For Medicaid patients age 18 to 44, it was 26 percent for chronic conditions versus 19 percent for acute conditions, that is, about one-third higher. In children under 17, the readmission rate was two-times higher, regardless of whether the initial stay involved surgical treatment, according to the data.

However, in privately-insured adults, ages 45 to 64, the 30-day readmission rate following surgical hospitalizations was similar across chronic and acute conditions.

The numbers which came from inpatient databases for 15 states (Arkansas, California, Florida, Hawaii, Louisiana, Massachusetts, Missouri, Nebraska, New Hampshire, New York, South Carolina, Tennessee, Utah, Virginia, and Washington) represent 42 percent of the U.S. population, according to the report.

Although the report didn't specify why readmission rates were higher for chronic conditions over acute conditions, it did point to associated factors of chronic cases: limitations on self-care, independent living and social interactions, as well as the need for ongoing intervention with medical products, services and special equipment.

As a quality measure with reimbursements on the line, hospitals are certainly keeping a watchful eye on their readmission rates.

For more information:
- read the AHRQ press release
- check out the data

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