Readmission likelihood increases 2.9 percent each day in rural Appalachia hospitals
Financial penalties for readmissions are mandated by the Hospital Readmission Reduction Program, a part of the Affordable Care Act.
Hospital readmissions cost hospitals about $26 billion annually, and research has found that, at least in the Southern Appalachia region, readmission likelihood increases by 2.9 percent in rural cities.
IMPACT
The data shows that healthcare facilities located in rural Southern Appalachia show readmission rates that are above the national average, which results in penalties under the Hospital Readmission Reduction Program, a part of the Affordable Care Act that penalizes hospitals with higher readmission rates for targeted diagnoses.
To assess and prevent the causes of these frequent readmissions, researchers performed a retrospective review of rural Southern Appalachia using regression modeling on variables like age, gender, length of stay, and various health conditions such as hypertension and psychiatric disorders.
That's when they saw the 2.9 percent increase in readmission likelihood. They also found that former smokers were more likely than those who had never smoked to be readmitted, and if patients were provided with smoking cessation education at discharge it decreased the likelihood of readmission.
The month a patient was discharged also was a factor, with discharge rates higher in March and August than, say, January. Research also revealed that patients with a diagnosis of COPD, diabetes mellitus, hypertension, psychiatric disorders and chronic renal failure had an increased likelihood of readmission as well.
In rural Southern Appalachia, the primary causes of readmissions were increased lengths of stay, a history of smoking and the presence of comorbid COPD, diabetes, hypertension, chronic renal failure and psychiatric disorders.
The authors recommended decreasing length of stay, discharging patients before 1 p.m., providing smoking cessation support education and controlling comorbid diagnoses.
THE TREND
Readmissions are a pesky issue for hospitals. Just last month, a University of Illinois at Chicago study found patients who receive care in a for-profit hospital are more likely to be readmitted than those who receive care in non-profit or public hospitals, indicating they suffer from the financial repercussions more consistently.
Numerous means of combating high readmission rates have been proposed, including measuring patient uncertainty.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
