Saturday, November 02, 2013

Inverse relationship between length of stay and readmission rate for heart failure

From a report in Circulation: Heart Failure:

Patients treated in countries with longer lengths of stay for heart failure hospitalizations had significantly lower rates of readmission within 30 days of randomization. Findings were similar among sites in the United States, where each 1-day increase in the mean length of stay at the site level was independently associated with a lower risk of all-cause and heart failure readmission.

The authors cite the unintended consequences of DRGs:

Since 1984, when the current reimbursement model was introduced in the United States, there have been strong incentives to reduce lengths of stay to maximize hospital profitability. The consequent reduction in hospital lengths of stay has been accompanied by increases in postdischarge readmission rates,17 which may have resulted in greater overall costs among patients with heart failure.

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