Supporters of keeping the center open say it also has one of the lowest
rates of readmission among centers of its kind.
Adherence to American Association for the Study of Liver Diseases (AASLD) Guidelines and Predictors
of Readmission in Cirrhotic Patients: A Single Center Experience
«Because interventions to reduce the risk
of readmission for any group of patients can be costly and labor intensive, identification of the highest risk cohort for readmission can allow more targeted intervention for this population of socially vulnerable patients.»
The researchers found a similar narrower
range of readmissions for patients treated for heart failure or pneumonia.
Medical evidence reports that up to 25 % of SLE patients require treatment in the hospital each year, accounting for more than 140,000 hospitalizations in the U.S. Moreover, SLE has the sixth highest rate
of readmission among all medical conditions in the U.S. according to a 2010 study by Elixhauser et al..
The
cause of her readmission into hospital was meningitis — infection of her nervous system, brain and spinal cord, by Ebola virus that remained from her initial infection.
An analysis of risk factors for hospital readmission following general surgery finds that a large
number of readmissions were not caused by suboptimal medical care or deterioration of medical conditions but by issues related to mental health, substance abuse, or homelessness, according to a study published online by JAMA Surgery.
The real question is not what the prospect of death does to a man's
prospect of readmission to society, but what it does to his prospect of change of heart.
«Skidmore's policy does enable students who have been sanctioned to seek readmission to the college, and in the
process of the readmission hearing, the college assesses the student's readiness to return, and considers whether sanctions have been followed during the period of suspension, and also looks at how the student plans to reintegrate him or herself into the community,» said Wise.
Broadening the
scope of the readmissions program to include admissions would be a small step in the right direction, they said, because many of the behaviors that stem from unnecessary admissions also lead to readmissions.
Smoking overall, however, was unrelated to the risk
of readmission without surgery, or for reoperation for reasons other than infections.
«Our findings suggest that hospitals may best achieve low rates
of readmission by employing strategies that lower readmission risk globally rather than for specific diagnoses or time periods after hospitalization,» said lead author Dr. Kumar Dharmarajan, a visiting scholar at the Center for Outcomes Research and Evaluation at Yale School of Medicine and cardiology fellow at Columbia University Medical Center.
The
subject of readmission rates has been of increasing concern to U.S. hospitals since October 2012, when the Centers for Medicare and Medicaid Services (CMS) tied readmissions to reimbursement as part of the Affordable Care Act, informally known as Obamacare.
«Many
cases of readmissions may truly be unavoidable in our current paradigms of care because we found socially fragile populations to be at as high risk as those that are medically fragile,» the authors write.
When comparing the costs for the program to the
costs of the readmissions averted, the researchers found a substantial savings.
Researchers found that patients with COPD who exercised 150 minutes a week or more had a 34 percent lower risk
of readmission within 30 days compared to those who were inactive.
«The time has come to shift the
focus of readmissions away from hospitals to a broader health systems approach,» they write.
A Medicare program that penalizes hospitals for high readmission rates was associated with a narrowing
of readmission disparities between black and white patients and between minority - serving hospitals and other hospitals...
The model that incorporates socioeconomic data showed a much narrower
range of readmissions, 15.3 percent to 17.1 percent.
For black patients with this form of unmet nursing care, the
odds of readmission were increased by 26 percent.
Important
causes of readmissions to address are: Errors in hospital and transition care; Low threshold for admission and readmission; Premature discharge because of pressure to vacate hospital beds.
These savings could be achieved by such strategies as reducing the number of hospitalizations (54 percent), reducing the
number of readmissions (49 percent), and reducing the number of emergency room visits (39 percent).
Using this knowledge to target patients at higher
risk of readmission, the study concluded, it may be possible to make progress toward the long - term goal of improving the quality and cost of healthcare and easing the risk to hospitals of CMS penalties for excessive readmissions.
For the individual procedures, the
rate of readmission ranged from 3.8 percent after hysterectomy to 14.9 percent after lower extremity vascular bypass.
What they found was just plain striking: Patients treated by female internists had lower rates of mortality (within 30 days of hospitalization) and lower rates
of readmission than those treated by male physicians.
When breastfeeding LP babies are discharged after 36 hours, they have higher rates
of readmission than breastfeeding fullterm babies, breastfeeding early preterm babies (small premies), and bottlefed LPs.
The breastfed late preterm babies who spent even a few hours in the NICU have a much lower rate
of readmission.
«If smoking is associated with elevated perioperative risk
of readmission and / or reoperation, then it may be reasonable to engage the patient in a smoking cessation program prior to total joint arthroplasty,» Dr. Austin and coauthors write.
Comparisons between groups may lead to spurious conclusions — a hospital that regularly admits substance abusers will have artificially low rates
of readmission, giving a false appearance of better performance.»
«Nursing home quality not tied to risk
of readmission or death following hospitalization, penn study finds.»
«Understanding differences in quality between hospitals is an important part of understanding why certain SNFs have higher rates
of readmission than others, and figuring out the contribution of hospitals and SNFs, both alone and in combination, to overall patterns of readmission, is an important next step for research,» adds Neuman.
As a whole, the team found that better performance in these quality measures was not consistently associated with lower adjusted risk
of readmission or death at 30 days.
The team found that the risk
of readmission or death within 30 days was lower for discharges from SNFs with better staffing ratings, better facility inspection ratings and lower rates of new or worsening pressure ulcers.
Rates
of readmission or death were also lower at nursing homes that had a higher percentage of patients with moderate to severe pain and acute delirium.
«Home health care visits after heart surgery significantly reduce risk
of readmission, death.»
Focusing on seven common inpatient pediatric conditions — asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders and epilepsy — the researchers then calculated the rates
of readmissions and revisits to the hospital within 30 and 60 days of discharge, broken down by the condition for which they were treated.
Hospitals with high rates
of readmissions are penalised financially and get less money from Medicare regardless of whether or not those readmissions could have been prevented.
«We've found that families not only want to promote healing, but patients benefit from someone who knows their preferences, and the result is, the rate
of readmissions is reduced after patients are discharged from the hospital.»
Patients treated by female physicians had 0.95 times the odds of death (95 % CI, 0.93 - 0.97; P <.001) and 0.96 time the odds
of readmission (95 % CI, 0.95 - 0.97; P <.001) compared with patients cared for by male physicians.
Nursing Home Quality Not Tied to Risk
of Readmission or Death Following Hospitalization, Penn Study Finds
Patient 25: A man admitted to hospital with congestive heart failure and 12 other medical conditions is discharged home without the necessary home care follow up, placing him at a much higher risk
of readmission.