Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis

Buhr, Russell G.; Jackson, Nicholas; Kominski, Gerald F.; Dubinett, Steven M.; Mangione, Carol M.; Ong, Michael

doi:10.1007/s11606-020-05958-0

Cited by 14 publications

(7 citation statements)

References 50 publications

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“…We conducted a retrospective analysis using a survey analysis technique of the Nationwide Readmissions Database (NRD) to study the trends of HF hospitalizations and readmissions, as done previously . The NRD is a publicly available all-payer database developed by the Agency for Healthcare Research and Quality for the Healthcare Cost and Utilization Project.…”

Section: Methodsmentioning

confidence: 99%

National Trends in Heart Failure Hospitalizations and Readmissions From 2010 to 2017

2021

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eart failure (HF) is one of the leading causes for hospital admission in the US, accounting for almost 6.5 million hospital days annually. 1 HF hospitalizations are at high risk of readmission, and such cumulative events are a strong predictor of mortality. 2 Previous studies have described the secular trends of overall HF hospitalizations, but the literature describing the national trends of unique index hospitalizations and readmission visits for the primary management of HF is lacking. [3][4][5][6][7][8][9] Hence, we examined contemporary overall and sex-specific trends of unique primary HF hospitalization and 30-day readmission visits in a large national US administrative database from 2010 to 2017. MethodsWe conducted a retrospective analysis using a survey analysis technique of the Nationwide Readmissions Database (NRD) to study the trends of HF hospitalizations and readmissions, as done previously. [10][11][12][13][14] The NRD is a publicly available all-payer database developed by the Agency for Healthcare Research and Quality for the Healthcare Cost and Utilization Project. The NRD provides accurate representation of total US hospitalizations and readmissions visits regardless of insurance provider. We identified all adult (17 years or older) hos-IMPORTANCE Previous studies have described the secular trends of overall heart failure (HF) hospitalizations, but the literature describing the national trends of unique index hospitalizations and readmission visits for the primary management of HF is lacking.OBJECTIVES To examine contemporary overall and sex-specific trends of unique primary HF (grouped by number of visits for the same patient in a given year) and 30-day readmission visits in a large national US administrative database from 2010 to 2017.

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Section: Methodsmentioning

confidence: 99%

National Trends in Heart Failure Hospitalizations and Readmissions From 2010 to 2017

2021

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“…It was estimated that approximately 20% of COPD patients were readmitted within 30 days 7 . Some countries have made efforts to reduce excess readmissions 8 – 10 . The Chinese government implemented policies to reduce medical costs by controlling the mean length of stay.…”

Section: Introductionmentioning

confidence: 99%

Secular trend and risk factors of 30-day COPD-related readmission in Beijing, China

Liang

Cao

et al. 2022

Sci Rep

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Readmission due to chronic obstructive pulmonary disease (COPD) exacerbation contributes significantly to disease burden. Trend in readmission rate among COPD patients in China is not well characterized. We described the secular trend and identify risk factors of COPD-related 30-day readmission in Beijing during 2012–2017. In this retrospective cohort study, we used data from a citywide hospital discharge database in Beijing. We included patients ≥ 40 years with a primary diagnosis of COPD from 2012 to 2017. A total of 131 591 index admissions were identified. COPD-related 30-day readmission was defined as the initial admission with a primary diagnosis of COPD that occurs within 30 days from the discharge date of an index admission. Overall and annual 30-day readmission rates were calculated in the total population and subgroups defined by patient characteristics. We used multivariable logistic models to investigate risk factors for readmission and in-hospital mortality within 30 days. The overall 30-day COPD-related readmission rate was 15.8% (n = 20 808). The readmission rate increased from 11.5% in 2012 to 17.2% in 2017, with a multivariable-adjusted OR (95% CI) for annual change to be 1.08 (1.06–1.09) (P trend < 0.001). The upward trend in readmission rate levelled off at about 17% since 2014. The readmission rate of men was higher and increased faster than women. Comorbid osteoporosis, coronary heart disease, congestive heart failure, and cancer were associated with an increased risk of 30-day COPD-related readmission. The 30-day COPD-related readmission rate in Beijing showed an overall increasing trend from 2012 to 2017. Future efforts should be made to further improve care quality and reduce early readmissions of COPD patients.

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“…We first examined characteristics of patient stays by race and discharge destination for 3 periods: January 2007 to March 2010 (pre-Affordable Care Act period), April 2010 to September 2012 (HRRP implementation period), and October 2012 to December 2017 (HRRP evaluation period)-consistent with previous HRRP analyses. [20][21][22] Next, we calculated the Black-White differences in ALOS for each year quarter stratified by targeted and non-targeted conditions, and separately by discharge destination. For ease of interpretation at the hospital-level, the ALOS differences were calculated per 100 admissions.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association Between Racial Disparities in Hospital Length of Stay and the Hospital Readmission Reduction Program

Ghosh

Soroka

Shapiro

et al. 2021

Health Services Research and Managerial Epidemiology

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Background: On average Black patients have longer LOS than comparable White patients. Longer hospital length of stay (LOS) may be associated with higher readmission risk. However, evidence suggests that the Hospital Readmission Reduction Program (HRRP) reduced overall racial differences in 30-day adjusted readmission risk. Yet, it is unclear whether the HRRP narrowed these LOS racial differences. Objective: We examined the relationship between Medicare-insured Black-White differences in average, adjusted LOS (ALOS) and the HRRP’s implementation and evaluation periods. Methods: Using 2009-2017 data from State Inpatient Dataset from New York, New Jersey, and Florida, we employed an interrupted time series analysis with multivariate generalized regression models controlling for patient, disease, and hospital characteristics. Results are reported per 100 admissions. Results: We found that for those discharged home, Black-White ALOS differences significantly widened by 4.15 days per 100 admissions (95% CI: 1.19 to 7.11, P < 0.001) for targeted conditions from before to after the HRRP implementation period, but narrowed in the HRRP evaluation period by 1.84 days per 100 admissions for every year-quarter (95% CI: −2.86 to −0.82, P < 0.001); for those discharged to non-home destinations, there was no significant change between HRRP periods, but ALOS differences widened over the study period. Black-White ALOS differences for non-targeted conditions remained unchanged regardless of HRRP phase and discharge destination. Conclusion: Increased LOS for Black patients may have played a role in reducing Black-White disparities in 30-day readmission risks for targeted conditions among patients discharged to home.

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Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis

Cited by 14 publications

References 50 publications

National Trends in Heart Failure Hospitalizations and Readmissions From 2010 to 2017

National Trends in Heart Failure Hospitalizations and Readmissions From 2010 to 2017

Secular trend and risk factors of 30-day COPD-related readmission in Beijing, China

Association Between Racial Disparities in Hospital Length of Stay and the Hospital Readmission Reduction Program

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