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Trends in 30- and 90-Day Readmission Rates for Heart Failure.

Publication ,  Journal Article
Khan, MS; Sreenivasan, J; Lateef, N; Abougergi, MS; Greene, SJ; Ahmad, T; Anker, SD; Fonarow, GC; Butler, J
Published in: Circ Heart Fail
April 2021

BACKGROUND: The impact of hospital readmission reduction program (HRRP) on heart failure (HF) outcomes has been debated. Limited data exist regarding trends of HF readmission rates beyond 30 days from all-payer sources. The aim of this study was to investigate temporal trends of 30- and 90-day HF readmissions rates from 2010 to 2017 in patients from all-payer sources. METHODS: The National Readmission Database was utilized to identify HF hospitalizations between 2010 and 2017. In the primary analysis, a linear trend in 30-day and 90-day readmissions from 2010 to 2017 was assessed. While in the secondary analysis, a change in aggregated 30- and 90-day all-cause and HF-specific readmissions pre-HRRP penalty phase (2010-2012) and post-HRRP penalties (2013-2017) was compared. Subgroup analyses were performed based on (1) Medicare versus non-Medicare insurance, (2) low versus high HF volume, and (3) HF with reduced versus preserved ejection fraction (heart failure with reduced ejection fraction and heart failure with preserved ejection fraction). Multiple logistic and adjusted linear regression analyses were performed for annual trends. RESULTS: A total of 6 669 313 index HF hospitalizations for 30-day, and 5 077 949 index HF hospitalizations for 90-day readmission, were included. Of these, 1 213 402 (18.2%) encounters had a readmission within 30 days, and 1 585 445 (31.2%) encounters had a readmission within 90 days. Between 2010 and 2017, both 30 and 90 days adjusted HF-specific and all-cause readmissions increased (8.1% to 8.7%, P trend 0.04, and 18.3% to 19.9%, P trend <0.001 for 30-day and 14.8% to 16.0% and 30.9% to 34.6% for 90-day, P trend <0.001 for both, respectively). Readmission rates were higher during the post-HRRP penalty period compared with pre-HRRP penalty phase (all-cause readmission 30 days: 18.6% versus 17.5%, P<0.001, all-cause readmission 90 days: 32.0% versus 29.9%, P<0.001) across all subgroups except among the low-volume hospitals. CONCLUSIONS: The rates of adjusted HF-specific and all-cause 30- and 90-day readmissions have increased from 2010 to 2017. Readmissions rates were higher during the HRRP phase across all subgroups except the low-volume hospitals.

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

April 2021

Volume

14

Issue

4

Start / End Page

e008335

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Quality of Health Care
  • Patient Readmission
  • Medicare
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cardiovascular System & Hematology
 

Citation

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Khan, M. S., Sreenivasan, J., Lateef, N., Abougergi, M. S., Greene, S. J., Ahmad, T., … Butler, J. (2021). Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail, 14(4), e008335. https://doi.org/10.1161/CIRCHEARTFAILURE.121.008335
Khan, Muhammad Shahzeb, Jayakumar Sreenivasan, Noman Lateef, Marwan S. Abougergi, Stephen J. Greene, Tariq Ahmad, Stefan D. Anker, Gregg C. Fonarow, and Javed Butler. “Trends in 30- and 90-Day Readmission Rates for Heart Failure.Circ Heart Fail 14, no. 4 (April 2021): e008335. https://doi.org/10.1161/CIRCHEARTFAILURE.121.008335.
Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, et al. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail. 2021 Apr;14(4):e008335.
Khan, Muhammad Shahzeb, et al. “Trends in 30- and 90-Day Readmission Rates for Heart Failure.Circ Heart Fail, vol. 14, no. 4, Apr. 2021, p. e008335. Pubmed, doi:10.1161/CIRCHEARTFAILURE.121.008335.
Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, Anker SD, Fonarow GC, Butler J. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail. 2021 Apr;14(4):e008335.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

April 2021

Volume

14

Issue

4

Start / End Page

e008335

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Quality of Health Care
  • Patient Readmission
  • Medicare
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cardiovascular System & Hematology