Despite efforts, few US hospitals decrease HF readmission rates

NATIONAL HARBOR, Md. — From 2009 and 2012, the rate of improvement in HF readmissions across U.S. hospitals was modest, despite national goals and increased efforts to promote reduction, researchers reported at the Heart Failure Society of America Annual Scientific Meeting.

Perspective from Matthew J. Wolf, MD, PhD

“Readmissions for HF are common and costly, with nearly one in four patients being readmitted within 30 days of discharge,” Kristin E. Bergethon, MD/MBA candidate at Duke Clinical Research Institute, said during a presentation. “In 2009, several national quality-improvement campaigns were launched, with stated goals of decreasing readmission rates by a relative 20% by 2012.”

The new study included 21,264 patients with HF from January 2009 to October 2012. Data were compiled using the American Heart Association’s Get With The Guidelines-HF registry, linked to Medicare claims data. Bergethon and colleagues examined data from 70 U.S. sites, and determined the number of hospitals that obtained a 20% relative reduction in risk-adjusted 30-day hospital readmissions for HF. Sites were stratified into quartiles of relative change; patient and hospital characteristics were then compared across quartiles.

According to Bergethon, the researchers found “a modest improvement” in risk-adjusted 30-day readmission rates for HF, from 20.2% in 2009 (standard deviation [SD], 1.63) to 19.05% in 2012 (SD, 1.59). The mean percentage change across hospitals was –4.4% (SD, 9.1). A 20% relative decrease in risk-adjusted 30-day HF readmission rates was observed in two out of 70 sites (2.9%).

“While there was slight improvement in 30-day readmissions over the past 4 years, few hospitals have seen large success,” Bergethon said. “Our data suggest that structural factors and teaching hospital status may have a bigger impact on readmission rates than previously assumed.” – by Julia Ernst, MS

References:

Bergethon KE, et al. Rapid Fire Abstracts I. Presented at: Heart Failure Society of America Annual Scientific Meeting; Sept. 26-29, 2015; National Harbor, Md.

Bergethon KE, et al. J Card Fail. 2015;doi:10.1016/j.cardfail.2015.06.068.

Disclosure: Bergethon reports no relevant financial disclosures.

Perspective

Matthew J. Wolf, MD, PhD

This abstract was particularly intriguing. It really suggests that we need to come up with better mechanisms to try and attain goals to reduce 30-day readmission, and also to even think about how we should potentially redefine these goals.

Matthew J. Wolf, MD, PhD

Associate professor, cardiovascular medicine

University of Virginia

Charlottesville, Va.

Disclosures: Wolf reports no relevant financial disclosures.