Rehospitalizations among patients in the Medicare fee-for-service program.

Results Almost one fifth (19.6%) of the 11,855,702 Medicare beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34.0% were rehospitalized within 90 days; 67.1% of patients who had been discharged with medical conditions and 51.5% of those who had been discharged after surgical procedures were rehospitalized or died within the first year after discharge. In the case of 50.2% of the patients who were rehospitalized within 30 days after a medical discharge to the community, there was no bill for a visit to a physician’s office between the time of discharge and rehospitalization. Among patients who were rehospitalized within 30 days after a surgical discharge, 70.5% were rehospitalized for a medical condition. We estimate that about 10% of rehospitalizations were likely to have been planned. The average stay of rehospitalized patients was 0.6 day longer than that of patients in the same diagnosis-related group whose most recent hospitalization had been at least 6 months previously. We estimate that the cost to Medicare of unplanned rehospitalizations in 2004 was $17.4 billion.

[1]  E P Steinberg,et al.  Hospital readmissions in the Medicare population. , 1984, The New England journal of medicine.

[2]  J. Blustein,et al.  The reliability of racial classifications in hospital discharge abstract data. , 1994, American journal of public health.

[3]  J L Freeman,et al.  Associations among hospital capacity, utilization, and mortality of US Medicare beneficiaries, controlling for sociodemographic factors. , 2000, Health services research.

[4]  M. Naylor,et al.  Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial , 2004, Journal of the American Geriatrics Society.

[5]  B. Friedman,et al.  The Rate and Cost of Hospital Readmissions for Preventable Conditions , 2004, Medical care research and review : MCRR.

[6]  G. Gazelle,et al.  A systematic meta-analysis of the efficacy and heterogeneity of disease management programs in congestive heart failure. , 2006, Journal of cardiac failure.

[7]  A. Ma,et al.  Assessment of the Medicare Quality Improvement Organization Program , 2006, Annals of Internal Medicine.

[8]  Sung-joon Min,et al.  The care transitions intervention: results of a randomized controlled trial. , 2006, Archives of internal medicine.

[9]  S. Radley,et al.  Unplanned general surgical re-admissions - how many, which patients and why? , 2007, Annals of the Royal College of Surgeons of England.

[10]  S. Enguídanos,et al.  Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative Care , 2007, Journal of the American Geriatrics Society.

[11]  A. Bonito,et al.  More Accurate Racial and Ethnic Codes for Medicare Administrative Data , 2008, Health care financing review.

[12]  Harlan M Krumholz,et al.  Statistical models and patient predictors of readmission for heart failure: a systematic review. , 2008, Archives of internal medicine.

[13]  Stephen A. Martin,et al.  A Reengineered Hospital Discharge Program to Decrease Rehospitalization , 2009, Annals of Internal Medicine.

[14]  Jennifer Schore,et al.  Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. , 2009, JAMA.