In 17-country MI readmissions race, U.S. finishes last

JAMA: U.S. patients also have shortest median LOS

Topics: Cardiovascular, Service Lines, Readmissions, Quality, Performance Improvement, Outcomes

January 05, 2012

Certain U.S. myocardial infarction patients are more likely to be readmitted within 30 days than their counterparts in 16 other countries, according to a new study in JAMA.

Researchers studied 5,745 patients from 296 hospitals in 17 countries—including Australia, Canada, and New Zealand—who were admitted for a ST-segment elevation myocardial infarction from July 2004 to May 2006. Overall, the findings showed that 11.3% of the 5,571 patients who survived to discharge were rehospitalized within 30 days.

However, the study found that 14.5% of U.S. patients were readmitted within 30 days, compared with only 9.9% in other countries. In addition, the researchers found that U.S. patients' median length of stay was shorter—three days, compared with "six, seven, or more in other countries," study author Manesh Patel said.

U.S. hospitals "provide more episodic care," Patel said, noting that "[o]ur systems of care may not be as integrated as they are in other countries." He suggested that the U.S. health care system establish a "link from the hospital to the primary care doctor to ensure that patients are getting set up in cardiac rehab and that they're following up with a cardiologist" (Gordon, HealthDay, 1/3; Steenhuysen, Reuters, 1/3; McKinney, Modern Healthcare, 1/3 [subscription required]).

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