Document Detail

Heart Failure Rehospitalization of the Medicare FFS Patient: A State-Level Analysis Exploring 30-Day Readmission Factors.
MedLine Citation:
PMID:  22660336     Owner:  NLM     Status:  Publisher    
PURPOSE OF STUDY:: Heart failure readmission among the elderly is frequent and costly to both the patient and the Medicare trust fund. In this study, the authors explore the factors that are associated with states having heart failure readmission rates that are higher than the U.S. national rate. PRIMARY PRACTICE SETTING(S):: Acute inpatient hospital settings METHODOLOGY AND SAMPLE:: 50 state-level data and multivariate regression analysis is used. The dependent variable Heart Failure 30-day Readmission Worse than U.S. Rate is based on adult Medicare Fee-for-Service patients hospitalized with a primary discharge diagnosis of heart failure and for which a subsequent inpatient readmission occurred within 30 days of their last discharge. RESULTS:: One key variable found-states with a higher resident population speaking a primary language other than English at home-that is significantly associated with a decrease in probability in states ranking "worse" on heart failure 30-day readmission. Whereas, states with a higher median income, more total days of care per 1,000 Medicare enrollees, and a greater percentage of Medicare enrollees with prescription drug coverage have a greater probability for heart failure 30-day readmission to be "worse" than the U.S. national rate. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE:: Case management interventions targeting health literacy may be more effective than other factors to improve state-level hospital status on heart failure 30-day readmission. Factors such as total days of care per 1,000 Medicare enrollees and improving patient access to postdischarge medication(s) may not be as important as literacy. Interventions aimed to prevent disparities should consider higher income population groups as vulnerable for readmission.
Mary Schmeida; Ronald A Savrin
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Publication Detail:
Journal Detail:
Title:  Professional case management     Volume:  17     ISSN:  1932-8095     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291585     Medline TA:  Prof Case Manag     Country:  -    
Other Details:
Languages:  ENG     Pagination:  155-161     Citation Subset:  -    
Mary Schmeida, MSN, PhD, is an expert in public health policy who has served in several key research positions and is also affiliated with Kent State University as adjunct faculty. Her research in health care and welfare policy has been published and presented nationally and internationally. Ronald A. Savrin, MD, MBA, is an internationally recognized vascular surgeon who has served as professor of surgery and has held numerous administrative, educational, and corporate appointments. He has led state and national quality improvement programs and is actively engaged in nationwide efforts to improve the medical care delivery system.
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