Readmissions rise as stays shorten: study

Patients hospitalized for heart failure are experiencing increasingly shorter lengths of stay and lower rates of in-hospital mortality, but their readmission rates have grown, according to a study examining 14 years of Medicare data, published in the June 2 issue of the Journal of the American Medical Association.

Using Medicare beneficiary data gathered from 1993 through 2006, researchers determined that the standardized use of acute-care interventions such as betablockers had likely played a role in shortening average lengths of stay 28%, from 8.81 days in 1993 to 6.33 days in 2006. There was also a 49% relative reduction in the in-hospital mortality rate, which dropped from 8.5% in 1993 to 4.3% in 2006.

By contrast, the 30-day hospital readmission rate increased 16.9%, from 17.2% to 20.1%. Additionally, the percentage of patients discharged to skilled-nursing facilities jumped by more than half, from 13% in 1993 to 19.9% in 2006.

“The most striking finding is that the period was associated with an increase in 30-day readmission rate,” the authors wrote. “Although we cannot demonstrate that the shortened hospital stay caused these changes, it is certainly plausible that the effort to discharge patients quickly has led to transfers to non-acute institutional settings and occasionally sent patients out of the hospital before they were fully treated.”