Academic hospital status was associated with higher all-cause (OR 1.24) and infection-related (OR 1.15) 30-day readmission rates, with infections accounting for 28% of all readmissions.
Cohort
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Does hospital population case-mix, including poverty, affect all-cause and infection-related 30-day readmission rates?
Infection-related readmissions account for nearly 30% of all-cause readmissions and are strongly associated with hospital case-mix factors including poverty, comorbidities, and discharge to skilled nursing facilities.
Odds Ratio: 1.24
BACKGROUND: Reducing hospital readmissions, including preventable healthcare-associated infections, is a national priority. The proportion of readmissions due to infections is not well-understood. Better understanding of hospital risk factors for readmissions and infection-related readmissions may help optimize interventions to prevent readmissions. METHODS: Retrospective cohort study of California acute care hospitals and their patient populations discharged between 2009 and 2011. Demographics, comorbidities, and socioeconomic status were entered into a hierarchical generalized linear mixed model predicting all-cause and infection-related readmissions. Crude verses adjusted hospital rankings were compared using Cohen's kappa. RESULTS: We assessed 30-day readmission rates from 323 hospitals, accounting for 213 879 194 post-discharge person-days of follow-up. Infection-related readmissions represented 28% of all readmissions and were associated with discharging a high proportion of patients to skilled nursing facilities. Hospitals serving populations with high proportions of males, comorbidities, prolonged length of stay, and populations living in a federal poverty area, had higher all-cause and infection-related readmission rates. Academic hospitals had higher all-cause and infection-related readmission rates (odds ratio 1.24 and 1.15, respectively). When comparing adjusted vs crude hospital rankings for infection-related readmission rates, adjustment revealed 31% of hospitals changed performance category for infection-related readmissions. CONCLUSIONS: Infection-related readmissions accounted for nearly 30% of all-cause readmissions. High hospital infection-related readmissions were associated with serving a high proportion of patients with comorbidities, long lengths of stay, discharge to skilled nursing facility, and those living in federal poverty areas. Preventability of these infections needs to be assessed.
Gohil et al. (Tue,) conducted a cohort in Hospital readmissions. Academic hospital status and high-risk population case-mix vs. Non-academic hospitals and lower-risk populations was evaluated on All-cause and infection-related 30-day readmissions (OR 1.24). Academic hospital status was associated with higher all-cause (OR 1.24) and infection-related (OR 1.15) 30-day readmission rates, with infections accounting for 28% of all readmissions.