Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Lawrence M. Simon, MD, Zuckerman School of Public Health, University of Arizona and Arizona State University, PO Box 874011, Tempe, AZ 85287-4011, 4809651622, mrimsza@asu.edu and Mary E. Rimsza, MD, School of Health Management and Policy, Arizona State University, PO Box 874011, Tempe, AZ 85287-4011.

Readmissions to hospitals account for up to 50% of all hospitalizations and 60% of hospital costs. Patients with chronic illnesses that require intensive care unit (ICU) admission are potentially at high risk for hospital readmission. An analysis of factors associated with this risk might suggest directions for health care resource efficiencies. Utilizing a unique community health data base, Arizona Health Query, which contains health care information on over 5 million Arizona residents, we examined the risk factors for hospital readmission of ICU patients with acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). We identified 693 patients >20 years old who received care in an intensive care unit in 2004 for these conditions and were discharged to home. 157 of these patients were readmitted to a hospital within 30 days of discharge, a readmission rate (RR) of approximately 23%. Hispanic patients were less likely to be readmitted than White non-Hispanic patients or Black patients. Patients with CHF (RR=29%) were more likely to be readmitted than patients with COPD (RR=18%) or AMI (RR=17%) Approximately 31% of patients over 80 years old and 26% of patients 70-79 years old at time of hospital discharge were readmitted within 30 days, compared to 14% of patients 20-39 years old and 21% of patients 40-69 years old. Approximately 26% of women were readmitted within 30 days compared to 20% of the men. Uninsured patients had the lowest readmission rate (18%) and publically insured patients had the highest rate (24%). Other risk factors which were analyzed included psychiatric comorbidities at the time of discharge and marital status..

Conclusions: Approximately 23% of adult patients with AMI, CHF, or COPD were readmitted to a hospital within 30 days of discharge to home after ICU care. Patients over 69 years old, women and those with CHF were at higher risk for hospital readmission after ICU care. This is a healthcare resource burden which may be addressed.

Learning Objectives:

• To determine risk factors associated with early readmission of patients discharged from ICU to home

Keywords: Chronic Diseases, Hospitals

Presenting author's disclosure statement:

Not Answered