Hospital Readmission Rates in U.S. States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster?

Abstract

Research Objective This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. Study Design The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to contextual and provider data from Health Resources and Services Administration. A multivariate cross sectional design at primary care service area (PCSA) level is used. Principal Findings Adjusting for area characteristics, the readmission rates were significantly higher in PCSAs having higher proportions of patients with 2–3 chronic conditions and those with 4+ chronic conditions, compared with areas with a higher concentration of patients with 0–1 chronic conditions. Conclusions Using small area analysis, the study shows that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.

Comparing Rates of Multiple Chronic Conditions at Primary Care and Mental Health Visits to Community Health Centers Versus Private Practice Providers

“…A chronic condition is a physical or mental health condition that lasts more than one year and causes functional restrictions or requires ongoing monitoring or treatment. 7 When a patient has more than one chronic condition-for example, diabetes, hypertension, and mood disorders-treatment can be difficult to manage. Treatment strategies or drug regimens may be similar-but can be very different-and one chronic condition may be better managed than the others.…”

Chronic illness and hospital readmission rate by adult age groups

“…Patients with multiple chronic conditions (MCC) have two or more chronic illnesses at the same time. Using both patient and area level data, [1,2] past studies had found MCC to be a major driver of readmissions. Past studies also found readmission risks to be higher among elderly than nonelderly adults because of poorer health status and increased number of comorbidities.…”

“…Past studies also found readmission risks to be higher among elderly than nonelderly adults because of poorer health status and increased number of comorbidities. [2] In this study, we particularly focus on a group of chronic con-ditions identified as subgroups of Ambulatory Care Sensitive Conditions (ACSCs), a well-used proxy measure for potentially preventable admissions that has been used in research, policy development and program design. These conditions are those that could exacerbate and lead to hospitalization if not prevented through better management in an ambulatory care setting.…”

“…[1] Also, because elderly have more chronic conditions, they have higher readmission risks than nonelderly adults. [2,5] Not much is known whether or how chronic conditions bur-den by types of chronic conditions are associated with readmission risks across age groups. It is not known, for example, whether 1) the hospitalized elderly with chronic ACSC will have higher risks of readmissions than those without, or relative to the nonelderly with chronic ACSC, or whether 2) readmission risks will increase uniformly across elderly and nonelderly in response to accumulation of chronic conditions (MCC), specifically within and across chronic condition categories (ACSCs and non-ACSCs).…”

Predicting Risk of Hospital Readmission for Comorbidity Patients through a Novel Deep Learning Framework

“…Hospitalized readmission has been receiving growing attentions [1] because of its implications on cost and quality of care in the most recent decade. Professional experts in the field mostly believe a remarkable number of readmissions are truly preventable [2]- [5].…”