TY  - BOOK
AU  - Lam, Phillip H
TI  - Association of 30-Day All-Cause Readmission with Long-Term Outcomes in Hospitalized Older Medicare Beneficiaries with Heart Failure
SN  - 0002-9343
PY  - 2016///
KW  - *Heart Failure/th [Therapy]
KW  - *Mortality
KW  - *Patient Readmission/sn [Statistics & Numerical Data]
KW  - Aged
KW  - Aged, 80 and over
KW  - Alabama/ep [Epidemiology]
KW  - Case-Control Studies
KW  - Cohort Studies
KW  - Comorbidity
KW  - Coronary Artery Disease/ep [Epidemiology]
KW  - Diabetes Mellitus/ep [Epidemiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Heart Failure/ep [Epidemiology]
KW  - Hospitalization
KW  - Humans
KW  - Male
KW  - Medicare
KW  - Middle Aged
KW  - Multivariate Analysis
KW  - Prognosis
KW  - Propensity Score
KW  - Proportional Hazards Models
KW  - Pulmonary Disease, Chronic Obstructive/ep [Epidemiology]
KW  - Renal Insufficiency, Chronic/ep [Epidemiology]
KW  - Treatment Outcome
KW  - United States
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present
N2  - BACKGROUND: Heart failure is the leading cause for 30-day all-cause readmission. We examined the impact of 30-day all-cause readmission on long-term outcomes and cost in a propensity score-matched study of hospitalized patients with heart failure; CONCLUSIONS: Among Medicare beneficiaries hospitalized for heart failure, 30-day all-cause readmission was associated with a higher risk of subsequent all-cause mortality, higher number of cumulative all-cause readmission, longer cumulative length of stay, and higher cumulative cost; Copyright Published by Elsevier Inc; METHODS: Of the 7578 Medicare beneficiaries discharged with a primary diagnosis of heart failure from 106 Alabama hospitals (1998-2001) and alive at 30 days after discharge, 1519 had a 30-day all-cause readmission. Using propensity scores for 30-day all-cause readmission, we assembled a matched cohort of 1516 pairs of patients with and without a 30-day all-cause readmission, balanced on 34 baseline characteristics (mean age 75 years, 56% women, 24% African American); RESULTS: During 2-12 months of follow-up after discharge from index hospitalization, all-cause mortality occurred in 41% and 27% of matched patients with and without a 30-day all-cause readmission, respectively (hazard ratio 1.68; 95% confidence interval 1.48-1.90; P <.001). This harmful association of 30-day all-cause readmission with mortality persisted during an average follow-up of 3.1 (maximum, 8.7) years (hazard ratio 1.33; 95% confidence interval 1.22-1.45; P <.001). Patients with a 30-day all-cause readmission had higher cumulative all-cause readmission (mean, 6.9 vs 5.1; P <.001), a longer cumulative length of stay (mean, 51 vs 43 days; P <.001), and a higher cumulative cost (mean,
UR  - https://dx.doi.org/10.1016/j.amjmed.2016.06.018
ER  -