Abstract
Background
Readmission following Heart failure (HF) hospitalization is common: 25% are readmitted
within a month of discharge and ≈50% within 6 months. A small proportion of these
patients can have multiple readmissions within this period, adding disproportionately
to the health care costs. In this study, we assessed the trends, predictors and costs
associated with multiple readmissions using National readmissions database (NRD).
Methods
We queried NRD for HF hospitalizations from 2010 to 2018 using ICD-9/10-CM codes.
Multinomial logistic regression was used to compare readmission cohorts, with the
multivariable model adjusting for other factors. All analyses accounted for the NRD
sampling design were conducted using SAS v. 9.4 with p < 0.05 used to indicate statistical significance.
Results
Within the study period, an estimated 6,763,201 HF hospitalizations were identified.
Of these, 58% had no readmission; 26% had 1 readmission; and 16% had ≥2 readmissions
within 90 days of index hospitalization. There was no statistically significant change
in readmission rates during the observation period. Multiple readmissions which accounted
for 37% of all readmissions contributed to 57% of readmission costs. Younger age was
identified as a predictor of multiple readmissions while sex, comorbidities and the
type of insurance were not significantly different from those with single readmission.
Conclusions
Multiple readmissions in HF are common (16%), have remained unchanged between 2010
and 2018 and impose a significant health care cost burden. Future research should
focus on identifying these patients for targeted intervention that may minimize excessive
readmissions particularly in those patients who are in the palliation phase of HF.
Keywords
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Article info
Publication history
Published online: September 21, 2022
Accepted:
September 12,
2022
Received:
October 17,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
