Trends And 30-Day Readmission Rate For Patients Discharged With Congestive Heart Failure: Analysis Of 2,352,612 Admissions
INTRODUCTION: Congestive heart failure (CHF) is a major cause of morbidity and mortality in USA with a huge economic burden on health care and is associated with a high re-admission rate (RR). This study was done to determine demographic parameters associated with high RR secondary to CHF.
METHODS: Nationwide Inpatient Sample data was used to extract data of patients discharged with Congestive heart failure for year 2012-2014 using clinical classification software (CCS) of 108, corresponding to ICD 9 codes of 398.91, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9. NIS represents 20% of all hospital data in US. All the patients who were discharged with primary diagnosis of CHF and readmitted within 30 days were identified and categorized based on admitting diagnosis. Patients were classified as readmissions secondary to CHF as a primary cause, readmissions with CHF as a secondary cause and non-CHF associated readmissions. Chi-square analysis was done for statistical significance.
RESULTS: We identified a total of 2,352,612 admissions for CHF nationwide during the study period with total 30-day RR of 53.5%. 30-day RR for CHF as primary diagnosis accounted for 8.5%. Age group (18-44), males, patients under Medicaid and living in metropolitan areas had higher 30-day RR secondary to CHF as a primary cause and non-CHF related causes (p<0.01).
CONCLUSION: Our study identifies the demographic parameters associated with high 30-day readmission rate for Congestive heart failure. It reveals that CHF is associated with high 30-day RR. Strategies to reduce morbidity and healthcare cost should be targeted more in these groups with high RR.