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Risk for hospital readmission increases among certain specialties

Hospital readmission risk increased for patients in surgical/gynecological and neurological cohorts but did not increase in medicine, cardiovascular or cardiorespiratory cohorts, according to research published in the Journal of Hospital Medicine.

Saul Blecker, MD, MHS, of New York University School of Medicine, and colleagues evaluated readmission rates of five clinical cohorts: surgery/gynecology, medicine, cardiovascular, cardiorespiratory and neurology.

“Hospitalization and readmission rates have decreased in recent years, with the possible consequence that hospitals are increasingly filled with high-risk patients,” the researchers wrote. “We studied whether readmission reduction has affected the risk profile of hospitalized patients and whether readmission reduction was similarly realized among hospitalizations with low, medium and high risk of readmissions.”

Researchers conducted a retrospective study of hospitalized fee-for-service Medicare beneficiaries that were categorized into one of the five specialty cohorts. Of 47,288,961 hospitalizations, 16.2% resulted in unplanned readmission within 30 days. Researchers also found that predicted risk of readmission increased by 0.24% and 0.13% per year for readmission in surgery/gynecology and neurology cohorts, respectively. 

The researchers found no increase in risk for readmission in the medicine, cardiovascular or cardiorespiratory cohorts.   

“In this 6-year, national study of Medicare hospitalizations, we found that readmission risk increased over time for surgical and neurological patients but did not increase in medicine or cardiorespiratory hospitalizations, even though those cohorts are known to have had substantial decreases in admissions and readmissions over the same time period,” the researchers wrote. “Moreover, we found that [observed to expected] readmissions decreased similarly for all hospitalized Medicare patients, whether of low, moderate, or high risk of readmission. These findings suggest that hospital efforts have resulted in improved outcomes across the risk spectrum.” – by Jake Scott

Disclosures: The researchers report no relevant financial disclosures.