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Hospital Care May Not Affect the Risk of Readmission

Johnson, Tricia PhD; Bardhan, Jaydeep PhD; Odwazny, Richard MS, FACHE; Harting, Brian MD; Skarupski, Kimberly PhD, MPH; McNutt, Robert MD, FACP

Quality Management in Health Care: April/June 2012 - Volume 21 - Issue 2 - p 68–73
doi: 10.1097/QMH.0b013e31824b9297
Original Articles
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Background: Thirty-day readmissions have become a focal point for reducing health care spending, because they are viewed as a marker of the quality of hospital care. However, if increased time in the hospital is associated with better care, attempts to shorten length of stay (LOS) may result in increased rates of readmission. As such, we sought to explore the association of an incremental added day in LOS with the rate of readmission.

Methods: We examined the rate of readmission at 30 and 120 days for 4151 patients admitted to a general internal medicine unit between July 2004 and March 2006. We used binary logistic regression to examine the relationship between an incremental added day in LOS and the probability of readmission.

Results: Readmission rates were 8.7% at 30 days and 21.0% at 120 days, respectively. After controlling for demographic characteristics and severity of illness, we found that the probability of readmission varied little for an incremental added day in LOS.

Conclusions: Our findings suggest that more hospital care may not affect the likelihood of readmission and thus denying payment for readmission may be unwarranted.

Departments of Health Systems Management (Drs Johnson, Skarupski, and McNutt and Mr Odwazny), Molecular Biophysics and Physiology (Dr Bardhan), and Internal Medicine (Mr Odwazny and Drs Harting, Skarupski, and McNutt), Rush Center for the Advancement of Patient Safety Research (Drs Johnson, Bardhan, Harting, and McNutt and Mr Odwazny) Rush University Medical Center, Chicago, Illinois.

Correspondence: Tricia Johnson, PhD, Department of Health Systems Management, Rush University, 1700 W Van Buren St; TOB Ste 126B, Chicago, IL 60612 (tricia_j_johnson@rush.edu).

The authors have no conflicts of interest.

©2012Lippincott Williams & Wilkins, Inc.