scholarly journals Short durations of corticosteroids for hospitalised COVID-19 patients are associated with a high readmission rate

2021 ◽  
Author(s):  
Zain Chaudhry ◽  
Marianne Shawe-Taylor ◽  
Tommy Rampling ◽  
Tim Cutfield ◽  
Gabriella Bidwell ◽  
...  
Keyword(s):  
Readmission Rate ◽  
High Readmission Rate

scholarly journals Trajectory Modelling to Assess Trends in Long-Term Readmission Rate among Abdominal Aortic Aneurysm Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Ahsan Rao ◽  
Alex Bottle ◽  
Collin Bicknell ◽  
Ara Darzi ◽  
Paul Aylin
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Readmission Rate ◽  
High Impact ◽  
Short Term ◽  
Readmission Rates ◽  
Abdominal Aortic ◽  
High Readmission Rate ◽  
Trajectory Modelling

Introduction. The aim of the study was to use trajectory analysis to categorise high-impact users based on their long-term readmission rate and identify their predictors following AAA (abdominal aortic aneurysm) repair. Methods. In this retrospective cohort study, group-based trajectory modelling (GBTM) was performed on the patient cohort (2006-2009) identified through national administrative data from all NHS English hospitals. Proc Traj software was used in SAS program to conduct GBTM, which classified patient population into groups based on their annual readmission rates during a 5-year period following primary AAA repair. Based on the trends of readmission rates, patients were classified into low- and high-impact users. The high-impact group had a higher annual readmission rate throughout 5-year follow-up. Short-term high-impact users had initial high readmission rate followed by rapid decline, whereas chronic high-impact users continued to have high readmission rate. Results. Based on the trends in readmission rates, GBTM classified elective AAA repair (n=16,973) patients into 2 groups: low impact (82.0%) and high impact (18.0%). High-impact users were significantly associated with female sex (P=0.001) undergoing other vascular procedures (P=0.003), poor socioeconomic status index (P<0.001), older age (P<0.001), and higher comorbidity score (P<0.001). The AUC for c-statistics was 0.84. Patients with ruptured AAA repair (n=4144) had 3 groups: low impact (82.7%), short-term high impact (7.2%), and chronic high impact (10.1%). Chronic high impact users were significantly associated with renal failure (P<0.001), heart failure (P = 0.01), peripheral vascular disease (P<0.001), female sex (P = 0.02), open repair (P<0.001), and undergoing other related procedures (P=0.05). The AUC for c-statistics was 0.71. Conclusion. Patients with persistent high readmission rates exist among AAA population; however, their readmissions and mortality are not related to AAA repair. They may benefit from optimization of their medical management of comorbidities perioperatively and during their follow-up.

scholarly journals Patient engagement with digital disease management and readmission rates: The case of congestive heart failure

2021 ◽  
Vol 27 (3) ◽  
pp. 146045822110309
Author(s):  
Rudin Gjeka ◽  
Kirit Patel ◽  
Chandra Reddy ◽  
Nora Zetsche
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Disease Management ◽  
Readmission Rate ◽  
Hospital Readmissions ◽  
The Elderly ◽  
Readmission Rates ◽  
Management Platform ◽  
High Readmission Rate ◽  
Remote Patient

Congestive heart failure (CHF) is one of the most common diagnoses in the elderly United States Medicare (⩾ age 65) population. This patient population has a particularly high readmission rate, with one estimate of the 6-month readmission rate topping 40%. The rapid rise of mobile health (mHealth) presents a promising new pathway for reducing hospital readmissions of CHF, and, more generally, the management of chronic conditions. Using a randomized research design and a multivariate regression model, we evaluated the effectiveness of a hybrid mHealth model—the integration of remote patient monitoring with an applied health technology and digital disease management platform—on 45-day hospital readmissions for patients diagnosed with CHF. We find a 78% decrease in the likelihood of CHF hospital readmission for patients who were assigned to the digital disease management platform as compared to patients assigned to control.

scholarly journals Hospitalization Events among Children and Adolescents with Sickle Cell Disease in Basra, Iraq

Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Zeina A. Salman ◽  
Meaad K. Hassan
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Readmission Rate ◽  
Length Of Hospital Stay ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Opioid Use ◽  
Asthma Symptoms ◽  
The Mean ◽  
High Readmission Rate

Objectives. Despite improvements in the management of sickle cell disease (SCD), many patients still experience disease-related complications requiring hospitalizations. The objectives of this study were to identify causes of hospitalization among these patients and factors associated with the length of hospital stay (LOS) and readmission.Methods. Data from 160 patients (<14 years old) with SCD who were admitted to the Basra Maternity and Children’s Hospital from the first of January 2012 through July 2012 were analyzed.Results. The main causes of hospitalization were acute painful crises (73.84%), infections (9.28%), acute chest syndrome (8.02%), and acute splenic sequestration crisis (6.32%). The mean LOS was4.34±2.85days. The LOS for patients on hydroxyurea (3.41±2.64days) was shorter than that for patients who were not (4.59±2.86days),P<0.05. The readmission rate (23.1%) was significantly higher among patients with frequent hospitalizations in the previous year (OR 9.352, 95% CI 2.011–43.49), asthma symptoms (OR 4.225, 95% CI 1.125–15.862), and opioid use (OR 6.588, 95% CI 1.104–30.336). Patients on hydroxyurea were less likely to be readmitted (OR 0.082, 95% CI 0.10–0.663).Conclusions. There is a relatively high readmission rate among patients with SCD in Basra. The use of hydroxyurea significantly decreases the LOS and readmission rate.

scholarly journals Transition of Care for Discharged Patients

2020 ◽  
Author(s):  
◽  
Rolando Ramos
Keyword(s):  
Readmission Rate ◽  
Transitional Care ◽  
Care Practice ◽  
Evidence Based ◽  
Transition Of Care ◽  
Practice Problem ◽  
Clinically Significant ◽  
High Readmission Rate ◽  
Hospital To Home ◽  
Avoidable Readmissions

Practice Problem: The 30-day readmission rate for patients discharged from the hospital and returned to their primary care in a clinical office setting (21%) was higher than the national average readmission rate (17%). The high readmission rate suggested patients were receiving transitional care that was fragmented and non-standardized. Therefore, the implementation of a collaborative transition of care practice was vital to reduce avoidable readmissions. PICOT: The PICOT question that guided this project was, “In adult patients with chronic conditions, what is the effect of a transition of care practice, versus a non-standardized practice, on reducing 30-day readmissions, within a 30-day period?” Evidence: Evidence suggests that implementing a multidisciplinary Transition of Care practice for patients who are discharged from the hospital to home decreases the 30-day readmission rate. Intervention: Using a multidisciplinary approach, the registered nurse implemented a Transition of Care practice, consisting of 10 evidence-based interventions, applied to help the patient transition from hospital to home. Outcome: The results of this project revealed a decrease in the 30-day readmission rate from 23% to 15%. Also, seven of the 10 interventions were successfully implemented at a rate of higher than 85%. Conclusion: The reduction in the percent of 30-day readmissions was statistically and clinically significant between the pre-transition of care and the post-transition of care participants. In addition, the transition of care interventions were successfully implemented to standardize an evidence-based practice for patients transitioning from the hospital to their home.

Mo1266 - High Readmission Rate in Necrotising Pancreatitis: Quality Index or Natural History of Disease?

2018 ◽  
Vol 154 (6) ◽  
pp. S-1330
Author(s):  
Sarakshi Mahajan ◽  
Thomas Maatman ◽  
Carl Schmidt ◽  
Eugene P. Ceppa ◽  
Michael G. House ◽  
...  
Keyword(s):  
Natural History ◽  
Readmission Rate ◽  
Quality Index ◽  
History Of Disease ◽  
Necrotising Pancreatitis ◽  
History Of ◽  
High Readmission Rate

High readmission rate after heart valve surgery: A nationwide cohort study

2015 ◽  
Vol 189 ◽  
pp. 96-104 ◽  
Author(s):  
K.L. Sibilitz ◽  
S.K. Berg ◽  
L.C. Thygesen ◽  
T.B. Hansen ◽  
L. Køber ◽  
...  
Keyword(s):  
Cohort Study ◽  
Heart Valve ◽  
Readmission Rate ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
High Readmission Rate

Abstract 15722: Demographic Factors for 30 Day Readmission Following Percutaneous Coronary Intervention Procedure: Analysis of Nationwide Inpatient Sample Data

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sourabh Aggarwal ◽  
Vishal Gupta
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Readmission Rate ◽  
Nationwide Inpatient Sample ◽  
Hospital Readmissions ◽  
Coronary Intervention ◽  
National Study ◽  
Demographic Parameters ◽  
Median Income ◽  
Percutaneous Coronary ◽  
High Readmission Rate

Introduction: Acute myocardial infarction is a major cause of morbidity and mortality in USA with percutaneous coronary intervention (PCI) as a mainstay of therapy. Short term hospital readmissions account for a significant portion of health care budget and much of the focus recently has been on reducing 30 day readmission rate. This study was done to determine demographic parameters associated with 30 day readmission rate after index PCI. Methods: Nationwide Inpatient Sample (NIS) data was used to extract data of patients discharged after PCI during index admission for years 2009-2011. Patients were identified by Clinical Classification Software code 45, corresponding to ICD 9 procedure codes of 00.66, 17.55, 36.01, 36.02 and 36.05. NIS represents 20% of all hospital data in US. Patients readmitted within 30 days were identified and demographic parameters associated with high readmission rate identified. Results: We identified a total of 1,784,929 hospitalizations where PCI was performed with 13.04% readmitted within 30 days after index hospitalizations. Elder age (65+), female gender, Medicaid insurance, low median income for zip code and metropolitan areas were associated with high 30 day readmission rate. Conclusions: This first national study identifies the demographic parameters associated with high 30 day readmission rate. Strategies to reduce morbidity and healthcare cost should be targeted more on these groups with high readmission rate. Study was limited by the fact that the admission for staged PCI could not he differentiated from unplanned readmission. Further studies might be needed to supplement the results.

scholarly journals Common Sequences of Emergency Readmissions among High-Impact Users following AAA Repair

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Ahsan Rao ◽  
Alex Bottle ◽  
Colin Bicknell ◽  
Ara Darzi ◽  
Paul Aylin
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Readmission Rate ◽  
High Impact ◽  
Aortic Graft ◽  
Abdominal Aortic ◽  
Number Of Patients ◽  
Common Causes ◽  
High Readmission Rate

Introduction. The aim of the study was to examine common sequences of causes of readmissions among those patients with multiple hospital admissions, high-impact users, after abdominal aortic aneurysm (AAA) repair and to focus on strategies to reduce long-term readmission rate. Methods. The patient cohort (2006–2009) included patients from Hospital Episodes Statistics, the national administrative data of all NHS English hospitals, and followed up for 5 years. Group-based trajectory modelling and sequence analysis were performed on the data. Results. From a total of 16,973 elective AAA repair patients, 18% (n=3055) were high-impact users. The high-impact users among ruptured abdominal aortic aneurysm (rAAA) repair constituted 17.3% of the patient population (n=4144). There were 2 subtypes of high-impact users, short-term (7.2%) with initial high readmission rate following by rapid decline and chronic high-impact (10.1%) with persistently high readmission rate. Common causes of readmissions following elective AAA repair were respiratory tract infection (7.3%), aortic graft complications (6.0%), unspecified chest pain (5.8%), and gastrointestinal haemorrhage (4.8%). However, high-impact users included significantly increased number of patients with multiple readmissions and distinct sequences of readmissions mainly consisting of COPD (4.7%), respiratory tract infection (4.7%), and ischaemic heart disease (3.3%). Conclusion. A significant number of patients were high-impact users after AAA repair. They had a common and distinct sequence of causes of readmissions following AAA repair, mainly consisting of cardiopulmonary conditions and aortic graft complications. The common causes of long-term mortality were not related to AAA repair. The quality of care can be improved by identifying these patients early and focusing on prevention of cardiopulmonary diseases in the community.

Total Hospital Costs and Readmission Rate of Patient-Specific Instrument in Total Knee Arthroplasty Patients

2020 ◽  
Author(s):  
Stephen Thomas ◽  
Ankur Patel ◽  
Corey Patrick ◽  
Gary Delhougne
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Hospital Cost ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Patient Specific ◽  
P Value ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Knee

AbstractDespite advancements in surgical technique and component design, implant loosening, stiffness, and instability remain leading causes of total knee arthroplasty (TKA) failure. Patient-specific instruments (PSI) aid in surgical precision and in implant positioning and ultimately reduce readmissions and revisions in TKA. The objective of the study was to evaluate total hospital cost and readmission rate at 30, 60, 90, and 365 days in PSI-guided TKA patients. We retrospectively reviewed patients who underwent a primary TKA for osteoarthritis from the Premier Perspective Database between 2014 and 2017 Q2. TKA with PSI patients were identified using appropriate keywords from billing records and compared against patients without PSI. Patients were excluded if they were < 21 years of age; outpatient hospital discharges; evidence of revision TKA; bilateral TKA in same discharge or different discharges. 1:1 propensity score matching was used to control patients, hospital, and clinical characteristics. Generalized Estimating Equation model with appropriate distribution and link function were used to estimate hospital related cost while logistic regression models were used to estimate 30, 60, and 90 days and 1-year readmission rate. The study matched 3,358 TKAs with PSI with TKA without PSI patients. Mean total hospital costs were statistically significantly (p < 0.0001) lower for TKA with PSI ($14,910; 95% confidence interval [CI]: $14,735–$15,087) than TKA without PSI patients ($16,018; 95% CI: $15,826–$16,212). TKA with PSI patients were 31% (odds ratio [OR]: 0.69; 95% CI: 0.51–0.95; p-value = 0.0218) less likely to be readmitted at 30 days; 35% (OR: 0.65; 95% CI: 0.50–0.86; p-value = 0.0022) less likely to be readmitted at 60 days; 32% (OR: 0.68; 95% CI: 0.53–0.88; p-value = 0.0031) less likely to be readmitted at 90 days; 28% (OR: 0.72; 95% CI: 0.60–0.86; p-value = 0.0004) less likely to be readmitted at 365 days than TKA without PSI patients. Hospitals and health care professionals can use retrospective real-world data to make informed decisions on using PSI to reduce hospital cost and readmission rate, and improve outcomes in TKA patients.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

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