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 August 23, 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 August 23, 2014).

Share This




More Health & Medicine News

Saturday, August 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) — An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) — Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) — Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) — It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. 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