Hospital length of stay and all‐cause 30‐day readmissions among high‐risk medicaid beneficiaries

Abstract

This study examined the association between index hospitalization characteristics and the risk of all-cause 30-day readmission among high-risk Medicaid beneficiaries using multi-level analyses. A retrospective cohort with a baseline and a follow-up period was used. The study population consisted of Medicaid beneficiaries (21-64 years) with selected chronic conditions, continuous fee-for-service enrollment through the observation period, and at least one inpatient encounter during the follow-up period (N=15,806). The outcome of 30-day readmission was measured using inpatient admissions within 30-days from the discharge date of the first observed hospitalization. Key independent variables included length of stay, reason for admission, and month of index hospitalization (seasonality). Multi-level logistic regression that accounted for beneficiaries nested within counties was used to examine this association, after controlling for patient-level and county-level characteristics. In this study population, 16.7% had all-cause 30-day readmissions. Adults with greater lengths of stay during the index hospitalization were more likely to have 30-day readmissions [AOR=1.03, 95% CI 1.02,1.04]. Adults who were hospitalized for cardiovascular conditions [AOR=1.20, 95% CI 1.08,1.33], diabetes [AOR=1.23, 95% CI 1.10,1.39], cancer [AOR=1.55, 95% CI 1.26,1.90], and mental health conditions [AOR=2.17, 95% CI 1.98,2.38] were more likely to have 30-day readmissions compared to those without these conditions.

Etiologies, predictors, and economic impact of readmission within 1 month among patients with takotsubo cardiomyopathy

“…Longer LOS has been shown to predict readmission in previous large-scale observational studies examining inpatients within the United States. 17,18 Patients who require longer hospital stays are commonly sicker than those who require shorter hospital stays, exposing them to a higher risk for early hospital readmission.…”

Risk factors for hospital readmission among Swedish older adults

“…It is possible that the readmission risk between diagnoses varies [ 27 , 36 ]. In this study, the most common primary diagnoses were cardiovascular diseases, both among the readmissions and the occasional hospitalizations.…”

“…In this study, the most common primary diagnoses were cardiovascular diseases, both among the readmissions and the occasional hospitalizations. Chopra and colleagues [ 36 ] found that persons with hospitalization due to cardiovascular diseases, diabetes and mental health conditions were more likely to have readmission within 30 days, compared to other conditions.…”

Length of Stay and Functional Outcomes Among Patients with Stroke Discharged from an Inpatient Rehabilitation Facility in Saudi Arabia

“…A previous observational study demonstrated that hospital readmission within 30 days for diagnoses such as heart failure, chronic obstructive pulmonary disease, acute myocardial infarction, community-acquired pneumonia, and gastrointestinal bleed decreased in conjunction with decreased LOS (from 5.44 to 3.98 days) [ 4 ]. Another study found that longer LOS for chronic conditions (e.g., coronary artery disease, congestive heart failure, and chronic kidney disease) was associated with marginally increased risk for rehospitalization (1.03, 95% confidence interval 1.02–1.04) [ 5 ]. These findings are important because hospital readmission is used as a quality indicator.…”