Johnson Tricia, Bardhan Jaydeep, Odwazny Richard, Harting Brian, Skarupski Kimberly, McNutt Robert
Departments of Health Systems Management, Rush University Medical Center, Chicago, Illinois 60612, USA.
Qual Manag Health Care. 2012 Apr-Jun;21(2):68-73. doi: 10.1097/QMH.0b013e31824b9297.
: Thirty-day readmissions have become a focal point for reducing health care spending, because they are viewed as a marker of the quality of hospital care. However, if increased time in the hospital is associated with better care, attempts to shorten length of stay (LOS) may result in increased rates of readmission. As such, we sought to explore the association of an incremental added day in LOS with the rate of readmission.
: We examined the rate of readmission at 30 and 120 days for 4151 patients admitted to a general internal medicine unit between July 2004 and March 2006. We used binary logistic regression to examine the relationship between an incremental added day in LOS and the probability of readmission.
: Readmission rates were 8.7% at 30 days and 21.0% at 120 days, respectively. After controlling for demographic characteristics and severity of illness, we found that the probability of readmission varied little for an incremental added day in LOS.
: Our findings suggest that more hospital care may not affect the likelihood of readmission and thus denying payment for readmission may be unwarranted.
30天再入院率已成为降低医疗保健支出的焦点，因为它被视为医院护理质量的一个指标。然而，如果住院时间延长与更好的护理相关，那么缩短住院时间（LOS）的尝试可能会导致再入院率上升。因此，我们试图探讨住院时间增加一天与再入院率之间的关联。
我们研究了2004年7月至2006年3月期间入住普通内科病房的4151例患者在30天和120天时的再入院率。我们使用二元逻辑回归来研究住院时间增加一天与再入院概率之间的关系。
30天的再入院率分别为8.7%，120天的再入院率为21.0%。在控制了人口统计学特征和疾病严重程度后，我们发现住院时间增加一天，再入院概率变化不大。
我们的研究结果表明，更多的住院护理可能不会影响再入院的可能性，因此拒绝支付再入院费用可能是没有道理的。
