PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

The Effects of Multiple Chronic Conditions on Adult Patient Readmissions and Hospital Finances: A Management Case Study.

Abstract Medicare and other payers have launched initiatives to reduce hospital utilization, especially targeting readmissions within 30 days of discharge. Hospital managers have traditionally contended that hospitals would prosper better by ignoring the penalties for high readmission rates and keeping the beds more full. We aimed to test the financial effects of admissions and readmissions by persons with and without specified chronic conditions in one regional hospital. This is a management case study with a descriptive brief report. This study was conducted at Winchester Memorial Hospital, a general hospital in a largely rural area of Virginia, 2010-2015. The total margin per admission varied by diagnosis, with the average patient diagnosed with chronic obstructive pulmonary disease, heart failure, pneumonia, or chronic renal disease having negative margins. The largest per-patient losses were in diagnostic categories coinciding with the highest readmission rates. The margin declined into substantial losses with an increasing number of chronic conditions, which also corresponded with higher readmission rates. Patients with 5 or more clinical conditions had highest risk of readmission within 30 days (24.8%) and had an average total loss of $865 per admission in 2015. The adverse financial effects worsened between 2010 and 2015. This hospital might improve its finances by investing in strategies to reduce chronic illness hospitalizations, especially those with multiple chronic conditions and high risk of readmission. These findings counter the common claim that the hospital would do better to fill beds rather than to work on efficient utilization. Other hospitals could replicate these analyses to understand their situations.
PMID
Related Publications

Frequency and diagnoses associated with 7- and 30-day readmission of skilled nursing facility patients to a nonteaching community hospital.

Associations between reduced hospital length of stay and 30-day readmission rate and mortality: 14-year experience in 129 Veterans Affairs hospitals.

Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions.

Chronic Obstructive Pulmonary Disease Readmissions and Other Measures of Hospital Quality.

Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions.

Authors

Mayor MeshTerms
Keywords

chronic disease

community health care

financial management

hospital

hospitals

management case studies

multiple chronic conditions

patient readmission

Journal Title inquiry : a journal of medical care organization, provision and financing
Publication Year Start




PMID- 28863719
OWN - NLM
STAT- MEDLINE
DA  - 20170902
DCOM- 20170912
LR  - 20170912
IS  - 1945-7243 (Electronic)
IS  - 0046-9580 (Linking)
VI  - 54
DP  - 2017 Jan 01
TI  - The Effects of Multiple Chronic Conditions on Adult Patient Readmissions and
      Hospital Finances: A Management Case Study.
PG  - 46958017729597
LID - 10.1177/0046958017729597 [doi]
AB  - Medicare and other payers have launched initiatives to reduce hospital
      utilization, especially targeting readmissions within 30 days of discharge.
      Hospital managers have traditionally contended that hospitals would prosper
      better by ignoring the penalties for high readmission rates and keeping the beds 
      more full. We aimed to test the financial effects of admissions and readmissions 
      by persons with and without specified chronic conditions in one regional
      hospital. This is a management case study with a descriptive brief report. This
      study was conducted at Winchester Memorial Hospital, a general hospital in a
      largely rural area of Virginia, 2010-2015. The total margin per admission varied 
      by diagnosis, with the average patient diagnosed with chronic obstructive
      pulmonary disease, heart failure, pneumonia, or chronic renal disease having
      negative margins. The largest per-patient losses were in diagnostic categories
      coinciding with the highest readmission rates. The margin declined into
      substantial losses with an increasing number of chronic conditions, which also
      corresponded with higher readmission rates. Patients with 5 or more clinical
      conditions had highest risk of readmission within 30 days (24.8%) and had an
      average total loss of $865 per admission in 2015. The adverse financial effects
      worsened between 2010 and 2015. This hospital might improve its finances by
      investing in strategies to reduce chronic illness hospitalizations, especially
      those with multiple chronic conditions and high risk of readmission. These
      findings counter the common claim that the hospital would do better to fill beds 
      rather than to work on efficient utilization. Other hospitals could replicate
      these analyses to understand their situations.
FAU - Mihailoff, Michael
AU  - Mihailoff M
AD  - 1 Winchester Medical Center, VA, USA.
FAU - Deb, Shreyasi
AU  - Deb S
AD  - 2 American Academy of Orthopaedic Surgeons, Washington, DC, USA.
FAU - Lee, James A
AU  - Lee JA
AD  - 3 Altarum Institute, Ann Arbor, MI, USA.
FAU - Lynn, Joanne
AU  - Lynn J
AD  - 4 Altarum Institute, Washington, DC, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Inquiry
JT  - Inquiry : a journal of medical care organization, provision and financing
JID - 0171671
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Bed Occupancy/*economics
MH  - Female
MH  - Hospitals, General/*economics
MH  - Hospitals, Rural/*economics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Chronic Conditions/*economics
MH  - Patient Readmission/*economics
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - chronic disease
OT  - community health care
OT  - financial management
OT  - hospital
OT  - hospitals
OT  - management case studies
OT  - multiple chronic conditions
OT  - patient readmission
EDAT- 2017/09/03 06:00
MHDA- 2017/09/13 06:00
CRDT- 2017/09/03 06:00
AID - 10.1177/0046958017729597 [doi]
PST - ppublish
SO  - Inquiry. 2017 Jan 1;54:46958017729597. doi: 10.1177/0046958017729597.