Impact of Antibiotic Choice on Pneumonia Readmission Rates

Hemenway, Alice N.; Naretta, Michael

doi:10.1097/mjt.0000000000000342

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…The all-cause pneumonia readmission rate for the entire sample in this study was 19.2%. This readmission rate was similar to prior research in which the all-cause pneumonia readmission rate was roughly 18% (Allaudeen et al, 2011;Dharmarajan et al, 2013;Epstein et al, 2011;Hemenway & Naretta, 2015;Suter et al, 2014).…”

Section: Research Questionsupporting

confidence: 89%

“…The HCUP measure allows a record to be both an index admission and a readmission, which is not consistent with the CMS measure that states that a discharge record cannot be both an index admission and a readmission (Barrett et al, 2012). These differences in technique can lead to discrepancies in reported readmission rates (Dharmarajan et al, 2013;Hemenway & Naretta, 2015;Hines et al, 2014;Mather et al, 2014;Navarro et al, 2012;Shorr et al, 2013;Suter et al, 2014). HCUP does not count transfer records as readmissions and combines transfers that occur on the same day as the index admission with the index admission into one record (Barrett et al, 2012).…”

Section: Published Methodologymentioning

confidence: 99%

“…A wide range of all-cause pneumonia readmission rates (10%-30%) has been reported due to varied methods of determining readmission rates (Allaudeen et al, 2011;Dharmarajan et al, 2013;Epstein, Jha, & Orav, 2011;Hemenway & Naretta, 2015;Hines et al, 2014;Joynt, Orav, & Jha, 2011b;Mather, Fortunato, Ash, Davis, & Kumar, 2014;Navarro, Enguídanos, & Wilber, 2012;Shorr et al, 2013;Suter et al, 2014). However, the most commonly reported all-cause pneumonia readmission rate is approximately 18% (Allaudeen et al, 2011;Dharmarajan et al, 2013;Epstein et al, 2011;Hemenway & Naretta, 2015;Suter et al, 2014). Allcause pneumonia readmission rates have been shown to vary across institutions (Epstein et al, 2011;Lindenauer et al, 2010; and across regions (Lindenauer et al, 2010).…”

Section: Problem Statementmentioning

confidence: 99%

“…Daeillo et al (2014) examined records from one state's Medicare claims data to determine the influence of dementia on hospital readmissions. As was described earlier in the paper, methods used to determine the rate of readmission can have a significant effect on the outcomes (Dharmarajan et al, 2013;Hemenway & Naretta, 2015;Hines et al, 2014;Mather et al, 2014;Navarro et al, 2012;Shorr et al, 2013;Suter et al, 2014). However, this study is the first to use a nationally representative sample to determine the all-cause pneumonia readmission rate for older adults with dementia.…”

Section: Research Questionmentioning

confidence: 99%

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Pneumonia Readmissions in Older Adults With Dementia

Knox

2019

Medical Care

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Objective:The purpose of this study was to investigate pneumonia readmissions of older adults with dementia. Readmission rates and predictive factors of older adults with and without dementia were compared in this study. Subjects: A nationally representative sample of 389,198 discharge records, representing 370,003 patients, was extracted from the 2013 Nationwide Readmission Database. Methods: Descriptive statistics were utilized to describe the demographics of the sample population. Differences between groups were analyzed using chi-square or t test statistics as appropriate. A generalized linear model was used to examine predictive factors for pneumonia readmissions.Results: Older adults with dementia had a readmission rate of 23.52% and were 2.9 times more likely to experience a pneumonia readmission than older adults without dementia.Significant differences in characteristics were found when comparing (a) older adults with and without dementia, (b) older adults with and without dementia who were readmitted, and (c) older adults with dementia who were and were not readmitted.Factors that significantly interacted with dementia included (a) discharge disposition, (b) number of chronic conditions, (c) risk of mortality, and (d) median household income. Conclusions:Classifying older adults with dementia as a high-risk group for pneumonia readmissions is supported by the findings of this study. More over, dementia diagnoses significantly affect discharge disposition, there are characteristic differences among older adults with dementia, and comorbidities and risk of mortality significantly affect pneumonia readmissions. Development of strategies to reduce pneumonia readmissions that are tailored to individuals with dementia should be considered.

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Section: Research Questionsupporting

confidence: 89%

Section: Published Methodologymentioning

confidence: 99%

Section: Problem Statementmentioning

confidence: 99%

Section: Research Questionmentioning

confidence: 99%

See 2 more Smart Citations

Pneumonia Readmissions in Older Adults With Dementia

Knox

2019

Medical Care

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Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients

López‐Alcalde

Rodríguez-Barrientos

Redondo-Sánchez³

et al. 2018

Cochrane Database of Systematic Reviews

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Effect of β-Lactam Plus Macrolide Versus Fluoroquinolone on 30-Day Readmissions for Community-Acquired Pneumonia

Gilbert

Arfstrom

Mihalovic

et al. 2020

American Journal of Therapeutics

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Background: Antibiotic therapy with a macrolide and β-lactam or a fluoroquinolone for the empirical treatment of community-acquired pneumonia (CAP) in an inpatient non–intensive care setting is recommended per guidelines. Studies show that these treatments have similar outcomes, including death, adverse effects, and bacterial eradication. However, a comparison of 30-day readmission rates between these treatments is limited. Study Question: To determine whether 30-day readmissions for patients treated for CAP in a regional hospital differed between a fluoroquinolone monotherapy and a β-lactam plus macrolide combination therapy. Study Design: Retrospective cohort study of patients aged ≥18 years with a CAP diagnosis who were admitted to the same regional hospital from December 1, 2011, through December 1, 2016. Measures and Outcomes: Patients receiving a third-generation cephalosporin plus macrolide were compared with those receiving a respiratory fluoroquinolone. Exclusion criteria were concurrent or recent use of the study antibiotics; death, transfer, or transition to hospice; and diagnosis of hospital-acquired pneumonia or health care–associated pneumonia. The collected data were 30-day readmission rates, antibiotic regimens, demographic characteristics, and pneumonia severity index and comorbidity scores. Association between treatment group and readmissions was assessed with logistic regression. Association between readmissions and individual data points between the 2 treatment groups was calculated with multivariate regression and odds ratio (95% confidence interval). Results: Of 432 patients, 171 met inclusion criteria (fluoroquinolone group, n = 101; β-lactam plus macrolide group, n = 70). Thirty-day readmissions were not significantly different between the fluoroquinolone group and β-lactam plus macrolide group (P = 0.58). Increased 30-day readmissions were independently associated with male sex and hospital length of stay (P < 0.05). Length of stay was approximately 3 days and did not differ between treatment groups. Conclusions: No difference was seen in 30-day readmissions between CAP patients who received fluoroquinolone monotherapy and those who received β-lactam plus macrolide combination therapy.

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Impact of Antibiotic Choice on Pneumonia Readmission Rates

Cited by 3 publications

References 16 publications

Pneumonia Readmissions in Older Adults With Dementia

Pneumonia Readmissions in Older Adults With Dementia

Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients

Effect of β-Lactam Plus Macrolide Versus Fluoroquinolone on 30-Day Readmissions for Community-Acquired Pneumonia

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