Abstract 17143: Shorter Length of Stay is Associated With Significantly Lower 30-day All-cause Readmission and 30-day All-cause Mortality in Older Medicare Beneficiaries Hospitalized for Heart Failure

Autor: Cherinne Arundel, Ali Ahmed, Rahul Khosla, Charles Faselis, Charity Morgan, Sijian Zhang, Marc Blackman, Ross D Fletcher, Wen-Chih Wu, Gregg C Fonarow, Prakash Deedwania, Javed Butler, Spyridon Deftereos, Wilbert S Aronow, Stefan D Anker, Richard M Allman
Rok vydání: 2015
Předmět:
Zdroj: Circulation. 132
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circ.132.suppl_3.17143
Popis: Background: A shorter hospital length of stay, encouraged by Prospective Payment System Act, may result in suboptimal care and early discharge. Heart failure (HF) is the leading cause for 30-day all-cause readmission. However, it is unknown whether hospitalized HF patients with a shorter length of stay may have higher 30-day all-cause readmission, the reduction of which is a goal of the Affordable Care Act. Methods: The 8049 Medicare beneficiaries hospitalized for HF and discharged alive from 106 U.S. hospitals (1998-2001) had a median length of stay of 5 days (interquartile, 4-8 days), of which 4272 (53%) had length of stay ≤ 5 days. Using propensity scores for length of stay 1-5 days, we assembled a matched cohort of 2788 pairs of patients with length of stay 1-5 and ≥6 days, balanced on 32 baseline characteristics. Results: 30-day all-cause readmission occurred in 19% and 23% of matched patients with length of stay 1-5 and ≥6 days, respectively (HR, 0.79; 95% CI, 0.70-0.89; Figure, left panel). When the length of stay of the 8049 pre-match patients was used as a continuous variable and adjusted for the same 32 variables, each day longer hospital stay was associated with a 2% higher risk of 30-day all-cause readmission (HR, 1.02; 95% CI, 1.01-1.03; p Conclusions: Among hospitalized patients with HF, length of stay 1-5 days (vs. longer) was associated with significantly lower 30-day all-cause readmissions and all-cause mortality that persisted throughout first year post-discharge.
Databáze: OpenAIRE
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