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National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999-2010.

Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM - PLoS ONE (2015)

Bottom Line: The post-MVS 1-year readmission rate declined from 1999-2010 (49.5% to 46.9%, P<0.01), and mean hospital LOS decreased from 6.2 to 5.3 (P<0.01).Among older adults surviving MVS to 1 year, slightly fewer than half experience a hospital readmission.There has been a modest decline in both the readmission rate and LOS over time, with worse outcomes in women and blacks.

View Article: PubMed Central - PubMed

Affiliation: Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, United States of America.

ABSTRACT

Background: Older patients who undergo mitral valve surgery (MVS) have high 1-year survival rates, but little is known about the experience of survivors. Our objective was to determine trends in 1-year hospital readmission rates and length of stay (LOS) in these individuals.

Methods: We included 100% of Medicare Fee-for-Service patients ≥65 years of age who underwent MVS between 1999-2010 and survived to 1 year (N = 146,877). We used proportional hazards regression to analyze the post-MVS 1-year readmission rate in each year, mean hospital LOS (after index admission), and readmission rates by subgroups (age, sex, race).

Results: The 1-year survival rate among patients undergoing MVS was 81.3%. Among survivors, 49.1% experienced a hospital readmission within 1 year. The post-MVS 1-year readmission rate declined from 1999-2010 (49.5% to 46.9%, P<0.01), and mean hospital LOS decreased from 6.2 to 5.3 (P<0.01). Readmission rates were highest in oldest patients, but declined in all age subgroups (65-74: 47.4% to 44.4%; 75-84: 51.4% to 49.2%, ≥85: 56.4% to 50.0%, all P<0.01). There were declines in women and men (women: 51.7% to 50.8%, P<0.01; men: 46.9% to 43.0%, P<0.01), and in whites and patients of other race, but not in blacks (whites: 49.0% to 46.2%, P<0.01; other: 55.0% to 48.9%, P<0.01; blacks: 58.1% to 59.0%, P = 0.18).

Conclusions: Among older adults surviving MVS to 1 year, slightly fewer than half experience a hospital readmission. There has been a modest decline in both the readmission rate and LOS over time, with worse outcomes in women and blacks.

No MeSH data available.


Related in: MedlinePlus

Overall trends in 1 year readmission rate and mean post-discharge length of stay in patients surviving to 1 year after mitral valve surgery, 1999–2010.The 1 year readmission rate declined from 49.5% (1999) to 46.9% (2010), and 1 year length of stay declined from 6.2 days (1999) to 5.3 days (2010).
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pone.0132470.g001: Overall trends in 1 year readmission rate and mean post-discharge length of stay in patients surviving to 1 year after mitral valve surgery, 1999–2010.The 1 year readmission rate declined from 49.5% (1999) to 46.9% (2010), and 1 year length of stay declined from 6.2 days (1999) to 5.3 days (2010).

Mentions: Overall, 49.1% of patients surviving MVS to 1 year were readmitted at least once within the 1-year period. There was a modest decline in the overall observed 1-year readmission rate [95% CI] from 1999 to 2010 (49.5% [48.6–50.4] to 46.9% [45.9–47.8]) (Fig 1 and Table A in S1 File). In 1999, the top four readmission diagnoses were heart failure (17.9%), arrhythmia (10.8%), postoperative complication (6.6%), and pneumonia (3.2%). In 2010, heart failure (20.2%) and arrhythmia (12.2%) remained the most common readmission diagnoses, followed by sepsis (4.4%) and postoperative complication (4.0%). Among those who were readmitted within 1 year, median (IQR) number of days to first readmission was 39 (123) in 1999 and 38 (124) in 2010 (P = 0.57).


National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999-2010.

Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM - PLoS ONE (2015)

Overall trends in 1 year readmission rate and mean post-discharge length of stay in patients surviving to 1 year after mitral valve surgery, 1999–2010.The 1 year readmission rate declined from 49.5% (1999) to 46.9% (2010), and 1 year length of stay declined from 6.2 days (1999) to 5.3 days (2010).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493110&req=5

pone.0132470.g001: Overall trends in 1 year readmission rate and mean post-discharge length of stay in patients surviving to 1 year after mitral valve surgery, 1999–2010.The 1 year readmission rate declined from 49.5% (1999) to 46.9% (2010), and 1 year length of stay declined from 6.2 days (1999) to 5.3 days (2010).
Mentions: Overall, 49.1% of patients surviving MVS to 1 year were readmitted at least once within the 1-year period. There was a modest decline in the overall observed 1-year readmission rate [95% CI] from 1999 to 2010 (49.5% [48.6–50.4] to 46.9% [45.9–47.8]) (Fig 1 and Table A in S1 File). In 1999, the top four readmission diagnoses were heart failure (17.9%), arrhythmia (10.8%), postoperative complication (6.6%), and pneumonia (3.2%). In 2010, heart failure (20.2%) and arrhythmia (12.2%) remained the most common readmission diagnoses, followed by sepsis (4.4%) and postoperative complication (4.0%). Among those who were readmitted within 1 year, median (IQR) number of days to first readmission was 39 (123) in 1999 and 38 (124) in 2010 (P = 0.57).

Bottom Line: The post-MVS 1-year readmission rate declined from 1999-2010 (49.5% to 46.9%, P<0.01), and mean hospital LOS decreased from 6.2 to 5.3 (P<0.01).Among older adults surviving MVS to 1 year, slightly fewer than half experience a hospital readmission.There has been a modest decline in both the readmission rate and LOS over time, with worse outcomes in women and blacks.

View Article: PubMed Central - PubMed

Affiliation: Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, United States of America.

ABSTRACT

Background: Older patients who undergo mitral valve surgery (MVS) have high 1-year survival rates, but little is known about the experience of survivors. Our objective was to determine trends in 1-year hospital readmission rates and length of stay (LOS) in these individuals.

Methods: We included 100% of Medicare Fee-for-Service patients ≥65 years of age who underwent MVS between 1999-2010 and survived to 1 year (N = 146,877). We used proportional hazards regression to analyze the post-MVS 1-year readmission rate in each year, mean hospital LOS (after index admission), and readmission rates by subgroups (age, sex, race).

Results: The 1-year survival rate among patients undergoing MVS was 81.3%. Among survivors, 49.1% experienced a hospital readmission within 1 year. The post-MVS 1-year readmission rate declined from 1999-2010 (49.5% to 46.9%, P<0.01), and mean hospital LOS decreased from 6.2 to 5.3 (P<0.01). Readmission rates were highest in oldest patients, but declined in all age subgroups (65-74: 47.4% to 44.4%; 75-84: 51.4% to 49.2%, ≥85: 56.4% to 50.0%, all P<0.01). There were declines in women and men (women: 51.7% to 50.8%, P<0.01; men: 46.9% to 43.0%, P<0.01), and in whites and patients of other race, but not in blacks (whites: 49.0% to 46.2%, P<0.01; other: 55.0% to 48.9%, P<0.01; blacks: 58.1% to 59.0%, P = 0.18).

Conclusions: Among older adults surviving MVS to 1 year, slightly fewer than half experience a hospital readmission. There has been a modest decline in both the readmission rate and LOS over time, with worse outcomes in women and blacks.

No MeSH data available.


Related in: MedlinePlus