One in Seven Injury-related Hospital Stays among Elderly Results in Readmission

A new AHRQ-funded study finds that about one in seven elderly patients (14 percent) admitted to the hospital for an injury will be readmitted within 30 days. The study examined 2006 data from hospitals in 11 States for admissions with a principal diagnosis of injury using AHRQ’s Healthcare Cost and Utilization Project State Inpatient Databases. The most common reasons for readmission were surgery of the upper or lower extremities, pneumonia, heart failure, septicemia and urinary tract infection. Three-quarters of patients admitted for injury were discharged to nursing homes or home health care. Patients who had severe injuries, received transfusions, experienced a patient safety event, had an infection, or were discharged to a nursing home or home health care had higher readmission rates. The study’s authors suggest that strategies to reduce readmission rates among elderly injury patients should focus on preventing complications and infections during the hospital stay and also address nursing home and home health care. The report, Thirty-Day, All-Cause Readmissions for Elderly Patients Who Have an Injury-related Inpatient Stay, was published in the October issue of Medical Care. Select to access the abstract on PubMed.®

Med Care. 2012 Oct;50(10):863-9.

Thirty-Day, All-cause Readmissions for Elderly Patients Who Have an Injury-related Inpatient Stay.

Spector WD, Mutter R, Owens P, Limcangco R.

Source

*Agency for Healthcare Research & Quality, Rockville †Social & Scientific Systems Inc., Silver Spring, MD.

Abstract

BACKGROUND:

: Policymakers are exploring ways to reduce readmission rates. Much attention has been given to readmissions for conditions such as heart failure, acute myocardial infarction, and pneumonia, but little attention has been given to readmissions of patients with injury-related index admissions.

METHODS:

: This analysis is a retrospective cohort study of elderly persons who are admitted to a community hospital for a principal diagnosis of injury. We use 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases from 11 States. With logistic regression we identify factors associated with a 30-day, all-cause inpatient readmission. Factors include: patient characteristics, injury characteristics, clinical experiences during the hospital stay, and hospital characteristics.

RESULTS:

: About 1 in 7 elderly patients with an injury-related admission were readmitted in 30 days (13.7%). We found that severe injuries had higher predicted readmission rates. Patients receiving transfusions, experiencing a Patient Safety Indicator event, and with infections had higher readmission rates. Patients discharged to nursing homes or home health care had higher readmission rates compared with patients discharged to the community.

CONCLUSIONS:

: This study expands evidence for the influence of injury characteristics on readmission rates. It also provides evidence about hospital experiences that affect readmissions. These findings suggest that a focus on preventing complications during the hospital stay may help reduce hospital-specific readmissions for patients with injury-related conditions. It also suggests that a strategy to reduce readmission rates should not only focus on hospitals but also nursing homes and home health care.