Congestive Heart Failure Who Is Likely to Be Readmitted?

• Published in: Medical care research and review Vol. 69; no. 5; pp. 602 - 616
• Main Authors: Coffey, Rosanna M., Misra, Arpit, Barrett, Marguerite, Andrews, Roxanne M., Mutter, Ryan, Moy, Ernest
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2012; SAGE PUBLICATIONS, INC
• Subjects: Aged; Aged, 80 and over; Congestive heart failure; Databases, Factual; Discharge; Female; Health care expenditures; Health costs; Health services utilization; Heart Failure; Hospitals; Humans; Likelihood Functions; Male; Medicaid; Medicaid - statistics & numerical data; Medicare; Medicare - statistics & numerical data; Middle Aged; Odds Ratio; Patient admissions; Patient Readmission - statistics & numerical data; Readmission; Treatment Refusal - statistics & numerical data; United States; United States; United States > US; Medicare; cost of index admission; congestive heart failure; readmissions; all payers; Medicaid; against medical advice
• ISSN: 1077-5587; 1552-6801
• DOI: 10.1177/1077558712448467

Readmission for congestive heart failure (CHF) is the most common reason for readmission among Medicare fee-for-service patients. Yet CHF readmissions are not just a Medicare problem. This study examined who is likely to be readmitted for CHF, using all-payer hospital discharges from 14 of the states participating in the Healthcare Cost and Utilization Project. Patients with the strongest positive association with readmission were discharged against medical advice, covered by Medicaid, and had more severe loss of function and certain comorbidities such as drug abuse, renal failure, or psychoses. Weak negative relationship between readmission and cost of index admission provides some evidence that hospitals with higher readmission rates do not systematically use fewer resources in treating patients in initial encounters. High readmission rate for Medicaid patients suggests that state and federal governments should target Medicaid populations and drug abuse treatment for better care coordination to reduce readmissions and health care costs.