Annals Internal Medicine, Author Interviews, Beth Israel Deaconess, Hospital Readmissions / 04.06.2015
Late Hospital Readmissions Linked To Chronic Health and Social Problems
MedicalResearch.com Interview with:
Kelly L. Graham, MD, MPH
Instructor in Medicine
Harvard Medical School Division of General Medicine and Primary Care
Beth Israel Deaconess Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Graham: 30-day readmissions have become a standard quality metric used to represent inpatient quality of care and unnecessary healthcare utilization. Effective 10/1/2009, hospitals with excess 30-day readmissions have been faced with financial penalties. Experts have questioned the validity of this metric, and have raised concerns about the potential unintended consequence of creating health disparities, as critical access hospitals caring for the most socioeconomically burdened patients have faced the highest penalties. We were interested to see if factors associated with readmissions in the early part of the 30 day window (0-7 days post-discharge) differed from those associated with the later window (8-30 days post-discharge), ultimately attempting to better understand the "pathophysiology" of a readmission.
Our findings suggest that early readmissions are associated with many factors, including those related to the index admission (acute illness burden and suboptimal discharge timing), and factors that are not related to the index hospitalization, such as chronic illness burden and social determinants of health. In contrast, late readmissions were only associated with chronic illness burden and social determinants of health.
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