Readmissions by Hospital Inpatient Service at the Community Level

Abstract

Background:  Hopsital Readmissions have become a focus for efforts to improve the efficiency and outcomes of care.  They have been expressed by studies of hospital utilization and payor initiatives.

Methods: The study employed the Potentially Preventable Readmissions system to identify readmissions by service in the data for the combined Syracuse hospitals in 2014 and 2015. For adult medicine, the service with the largest number of readmissions, the study evaluated utilization by Major Diagnostic Category, Severity of Illness, and the relationship between the diagnoses of the initial admission and readmission which followed them.

Results: The study demonstrated that adult medicine accounted for 76-77 percent of readmissions, mental health was associated with 10-11 percent of readmissions.  Adult surgery, pediatrics, and obstetrics were each associated with fewer than 7 percent of readmissions.

These data suggested that approximately 40 percent of adult medicine readmissions were at Minor and Extreme severity of illness and 19 percent were for the same diagnosis as the initial admission.  These populations had the highest potential for avoiding rehospitalization.

Discussion:  The study demonstrated that adult medicine patients accounted for the largest percentage of hospital readmissions.  It suggested that the clinical management process should involve identification of patients with the greatest potential for reducing readmissions and interventions to address this ojective.  It also suggested that policy makers and payors should support these activities.