Burden of Hospital Readmission for Congestive Heart Failure In South Carolina

OBJECTIVE The purpose of this study is to describe the burden of hospital readmission for congestive heart failure (CHF) and to its co-morbidity of other illnesses.

BACKGROUND CHF is the leading cause of hospitalization for the elderly and is the leading cause of readmission within 30 days among the Medicare population.

METHODS The South Carolina Hospital Discharge dataset was analyzed to identify patients who were admitted for CHF as their primary diagnosis during 2008. This cohort of CHF patients were followed to study those that were rehospitalized for CHF during 2008. The differences between patients readmitted and those not readmitted were analyzed by gender, race, age group, source of pay, average length of stay, and average total charge. The Co-morbidity illnesses were determined by searching the principle ICD-9-CM diagnoses code and secondary diagnosis codes. Total comorbid disease was quantified according to the method of Charleson-Deyo index.

RESULTS During 2008, there were 16,293 hospitalizations with CHF as their primary diagnosis. There were 1,536 that were rehospitalized within 30 days for CHF. The majority were white patients and 60% were over the age of 65. The Charleson-Deyo Index analysis of 11,884 CHF patients revealed that 80% had a value of two or more co-morbidity.

CONCLUSIONS This growing burden of CHF will have a substantial impact on our health care system, especially with the progressive aging of the U.S. population. Identifying those at a higher risk of readmission for CHF and enrolling in proactive care management programs may reduce preventable hospital readmissions.