Featured Research

from universities, journals, and other organizations

Role of chronic medical conditions in readmissions

Date:
December 23, 2013
Source:
Brigham and Women's Hospital
Summary:
In new findings, researchers find that the most frequent reasons for readmission were often related, either directly or indirectly, to patients' underlying chronic medical conditions (comorbidities), providing a new opportunity for focus in reducing readmission rates.

Not only are hospital readmissions a costly problem for patients and for the health care system, with studies showing nearly 20 percent of Medicare patients are readmitted to the hospital at an annual cost of $17 billion, but they also pose a significant opportunity for improved patient care and safety. They also represent a complex, multi-faceted issue that still needs to be better understood. In new findings from Brigham and Women's Hospital (BWH), researchers find that the most frequent reasons for readmission were often related, either directly or indirectly, to patients' underlying chronic medical conditions (comorbidities), providing a new opportunity for focus in reducing readmission rates.

This research is published online in the British Medical Journal on December 16, 2013 and will appear in the January print edition.

"We know that the reason for readmission is often different from the reason that the patient was initially hospitalized. Our research shows that the five most frequent reasons for readmission were often related to patients' existing chronic medical conditions, underscoring the need for post-discharge care to focus attention not just on the primary diagnosis of the previous hospitalization but also on these comorbidities," said Jacques Donzι, MD, MSc, a research associate in the Division of General Internal Medicine at BWH and lead author of the new research.

Researchers evaluated the primary diagnoses and patterns of 30-day readmissions and potentially avoidable readmissions according to seven most common comorbidities in medical patients (chronic heart failure, ischemic heart disease, atrial fibrillation, diabetes mellitus, cancer, chronic obstructive pulmonary disease, and chronic kidney disease). They analyzed data from 10,731 discharges, of which, 2,398 or 22 percent, were followed by a 30-day readmission at three hospitals within the same hospital network. Among the readmissions, 858, or 8 percent, were categorized as potentially avoidable.

Among the potentially avoidable readmissions, the overall three most common reasons for readmission were infection, cancer and heart failure. Heart failure and infection were the two most frequent main readmission diagnosis for the seven chronic medical conditions studied, accounting for 21 to 34 percent of all potentially avoidable readmissions. Interestingly, almost all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity. For example, patients discharged with a comorbidity of cancer were most frequently readmitted for care of their cancer or possibly related complications like infection, metabolic disorder, gastro-intestinal disorder, or renal failure. Heart failure was the most frequent main readmission diagnosis for patients with five of the seven chronic medical conditions studied.

Particularly important, researchers note that patients with cancer, heart failure, and chronic kidney disease had a significantly higher risk of potentially avoidable readmission than those without those comorbidities.

"Transitions of care should not only focus on the acute condition responsible for the hospitalization, but also on patients' underlying chronic conditions that may increase the risk of new, acute complications," said Donzι. "Our research suggests that interventions could include close follow-up and monitoring of patients' comorbidities in the post-discharge period, when we know that patients are particularly vulnerable."


Story Source:

The above story is based on materials provided by Brigham and Women's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. J. Donze, S. Lipsitz, D. W. Bates, J. L. Schnipper. Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study. BMJ, 2013; 347 (dec16 4): f7171 DOI: 10.1136/bmj.f7171

Cite This Page:

Brigham and Women's Hospital. "Role of chronic medical conditions in readmissions." ScienceDaily. ScienceDaily, 23 December 2013. <www.sciencedaily.com/releases/2013/12/131223114846.htm>.
Brigham and Women's Hospital. (2013, December 23). Role of chronic medical conditions in readmissions. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2013/12/131223114846.htm
Brigham and Women's Hospital. "Role of chronic medical conditions in readmissions." ScienceDaily. www.sciencedaily.com/releases/2013/12/131223114846.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) — Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) — Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) — At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) — The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:  

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile iPhone Android Web
      Follow Facebook Twitter Google+
      Subscribe RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins