A Research study findings published in the Sept. 20 issue of the Journal of the American Heart Association noted that patients readmitted to the discharging hospital after myocardial infarction (MI) do not have significant differences in outcomes compared with those who are readmitted to another hospital.
According to Nov. 26 statement discussing the article, Jennifer A. Rymer, MD, MBA and University Medical researchers, linkeddata from American College of Cardiology’s (ACC) Chest Pain – MI Registry with claims data from the Centers for Medicare and Medicaid Services to look at patterns in 30-day post-MI readmissions, stratified by the discharging hospital vs. non-discharging hospital.
The study’s findings examining 53,471 MI patients who were discharged, 7,715 (14.4 percent) were readmitted within 30 days. Among the readmitted patients, 5,595 (73 percent) returned to the discharging hospital. Patients who were readmitted to a non-discharging hospital were more likely to live in areas with lower household incomes and lower educational levels than those admitted to the discharging hospital.
The researchers said that among all readmitted patients, 1,746 (22.6 percent) were readmitted for conditions similar to their original diagnosis, 2,480 (32.1 percent) for conditions that may have been related to the MI, and 3,489 (45.2 percent) for other diagnoses.
There was not a significant difference in length of stay for those readmitted to the discharge hospital vs. another hospital (4 days vs. 3 days), says the study’s findings. Of readmitted patients, 579 (7.5 percent) died within 30 days and 1,655 (21.5 percent) died with six months of the original discharge date. Mortality did not differ significantly between patients who were readmitted to the discharge hospital vs. another hospital at 30 days (7.4 percent vs. 7.7 percent) or at six months (21.8 percent vs. 20.5 percent).
Looking at the Data
Though there has been an increased effort on trying to maintain continuity of care, the clinical implications of this analysis would suggest that for post–myocardial infarction readmissions, the location of readmission is not associated with an increased length of stay or an increased mortality risk, say the researchers.
According to the researchers, the study findings indicate that it is \”increasingly important for hospitals to work together as a regional network to prevent unnecessary readmissions both at their own institution as well as neighboring institutions.\” Readmission to a new hospital was not associated with a longer length of stay or higher mortality, they conclude, adding these \”patterns are reassuring with respect to continuity of care and patient outcomes.\”
This study was funded by the American College of Cardiology National Cardiovascular Data Registry, and analyses were performed by the data analysis center at the Duke Clinical Research Institute (Durham, NC).