Study Uses NCDR and CMS Claims Data to Examine Patterns in 30-Day Post-MI Readmissions

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Patients readmitted to the discharging hospital after myocardial infarction (MI) do not have significant differences in outcomes compared with those who are readmitted to another hospital, according to a study published Sept. 20 in the Journal of the American Heart Association.

Jennifer A. Rymer, MD, MBA, et al., linked data from ACC's Chest Pain – MI Registry with claims data from the Centers for Medicare and Medicaid Services to examine patterns in 30-day post-MI readmissions, stratified by the discharging hospital vs. nondischarging hospital.

According to the results, of the 53,471 MI patients who were discharged, 7,715 (14.4 percent) were readmitted within 30 days. Among the readmitted patients, 5,595 (73 percent) returned to the discharging hospital. Patients who were readmitted to a nondischarging hospital were more likely to live in areas with lower household incomes and lower educational levels than those admitted to the discharging hospital. Among all readmitted patients, 1,746 (22.6 percent) were readmitted for conditions similar to their original diagnosis, 2,480 (32.1 percent) for conditions that may have been related to the MI, and 3,489 (45.2 percent) for other diagnoses.

There was not a significant difference in length of stay for those readmitted to the discharge hospital vs. another hospital (4 days vs. 3 days). Of readmitted patients, 579 (7.5 percent) died within 30 days and 1,655 (21.5 percent) died with six months of the original discharge date. Mortality did not differ significantly between patients who were readmitted to the discharge hospital vs. another hospital at 30 days (7.4 percent vs. 7.7 percent) or at six months (21.8 percent vs. 20.5 percent).

According to the authors, the results suggest it is "increasingly important for hospitals to work together as a regional network to prevent unnecessary readmissions both at their own institution as well as neighboring institutions." Readmission to a new hospital was not associated with a longer length of stay or higher mortality, they conclude, adding these "patterns are reassuring with respect to continuity of care and patient outcomes."

Keywords: Patient Readmission, Length of Stay, Patient Discharge, Registries, Myocardial Infarction, Chest Pain, National Cardiovascular Data Registries, Chest Pain MI Registry

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