Hospital Revisits Occur Frequently After Discharge for Medicare Benificiaries

HealthDay News — For Medicare beneficiaries age 65 years and older, hospital revisits frequently occur after discharge from observation stays, and have increased over time, according to a study published online in The BMJ.

Kumar Dharmarajan, MD, MBA, from the Yale University School of Medicine in New Haven, Connecticut, and colleagues conducted a retrospective cohort study in 4750 U.S. hospitals. Data were included for Medicare fee-for-service beneficiaries aged 65 years or older discharged after 363,037 index observation stays, 2,540,000 index emergency department treatment-and-discharge stays, and 2,667,525 index inpatient stays during 2006 to 2011.

The researchers found that among the index observation stays, the 30-day rates of emergency department treatment-and-discharge stays, repeat observation stays, and inpatient stays were 8.4, 2.9, and 11.2 percent, respectively; the rate of any hospital revisit was 20.1 percent and death was 1.8 percent. Almost half (49.7 percent) of all revisits were for inpatient stays. From 2006 to 2011 there was an increase in revisit rates for emergency department treatment-and-discharge stays, repeat observation stays, and any hospital revisit (P < 0.001 for trend); there were no changes in 30-day rates of inpatient stays (P = 0.054) and 30-day mortality (P = 0.091).

“Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries,” the authors write.

Several authors disclosed financial ties to the pharmaceutical, medical device, and health care industries.

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Dharmarajan K, Qin L, Bierlein M, et al. Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study. BMJ. 2017; doi: 10.1136/bmj.j2616.