AHRQ: The conditions that cause the most readmissions

There were about 3.3 million readmissions in 2011

The Agency for Healthcare Research and Quality (AHRQ) has released a statistical brief on the conditions that caused the most readmissions in 2011—and how much those readmissions cost.

The brief was released as part of the group's Healthcare Cost and Utilization Project. "Identifying conditions that contribute the most to the total number of readmissions and related costs for all payers may aid health care stakeholders in deciding which conditions to target to maximize quality improvement and cost-reduction efforts," according to the brief.

Overall, AHRQ found that there were about 3.3 million 30-day readmissions in the United States. Those readmissions contributed to about $41 billion in hospital costs.

The most common readmissions for Medicare patients

Medicare patients accounted for more than 55% of all readmissions and 58.2% of the costs associated with readmissions. The five conditions with the most Medicare readmissions in 2011 were:

  • Congestive heart failure, non-hypertensive (which had 134,500 30-day readmissions);
  • Septicemia, not including labor (92,900 readmissions);
  • Pneumonia, not including that caused by STIs or tuberculosis (88,800 readmissions);
  • Chronic obstructive pulmonary disease and bronchiectasis (77,900 readmissions); and
  • Cardiac dysrhythmias (69,400 readmissions).

Infographics: A look at hospital infection rates in your state

The most common readmissions for Medicaid patients

Medicaid patients accounted for 20.6% of all readmissions and 18.4% of the associated costs. The five conditions with the most Medicaid readmissions in 2011 were:

  • Mood disorders (41,600 readmissions);
  • Schizophrenia and other psychotic disorders (35,800 readmissions);
  • Diabetes mellitus with complications (23,700 readmissions);
  • Complications of pregnancy, not including early or threatened labor (21,500 readmissions); and
  • Alcohol-related disorders (20,500).

Has your state improved mental health care since Newtown?

The most common readmissions for privately insured patients

Privately insured patients accounted for 18.6% of all readmissions and 19.6% of the associated costs. The five conditions with the most readmissions for privately insured patients in 2011 were:

  • Maintenance of chemotherapy or radiotherapy (25,500 readmissions);
  • Mood disorders (19,600 readmissions);
  • Complications of surgical procedures r medical care (18,000 readmissions);
  • Complications of device, implant, or graft (16,900 readmissions); and
  • Septicemia, except in labor (14,800 readmissions).

Also from AHRQ: The five most expensive surgeries in America

The most common readmissions for uninsured patients

Uninsured patients accounted for 4.9% of all readmissions and 3.7% of the associated costs. The five conditions with the most readmissions for uninsured patients in 2011 were:

  • Mood disorders (12,200 readmissions);
  • Alcohol-related disorders (8,800 readmissions);
  • Diabetes mellitus with complications (7,400 readmissions);
  • Pancreatic disorders, not diabetes (5,800 readmissions); and
  • Skin and subcutaneous tissue infections (4,200 readmissions).

What it takes to qualify for Medicaid in each state

Sources: Hines et al., AHRQ brief, April 2014; Herman, Becker's Hospital Review, 4/18

We can help you reduce readmissions

Check out two key resources to help your hospital cut readmissions:

Reducing Preventable Readmissions. This popular study outlines best practices for elevating transitions and disease management to prefect care across the continuum.

Nurse-Led Strategies for Preventing Avoidable Readmissions. Get 14 best practices for preventing avoidable readmissions by leveraging the inpatient stay to equip patients for long-term self-management and facilitating seamless transfers to post-acute care settings.


Next in the Daily Briefing

NYT: Bone-marrow transplants have an 'image problem'

Read now