Abstract 13793: National Survey of Care Processes to Reduce Readmission in Patients Hospitalized for Heart Failure: Factors Associated with Lower Readmission Rates
Background: Reducing heart failure (HF) 30-day rehospitalization rates is a national priority. Little is known on how hospitals are attempting to accomplish this goal or what processes are associated with reduced readmission rates.
Methods: We surveyed 100 randomly selected hospitals participating in the AHA GWTG-HF program to evaluate inpatient, discharge, and transitional care processes. The survey was developed with expert and focus group input to identify care process variables potentially related to readmission. Each hospital was scored within 3 domains: inpatient care processes; discharge processes and care transitions; and quality improvement based on exceeds, meets, or does not meet typical standards. In addition, hospitals were given a continuous score for each domain based on the number of positive responses for each item within a given domain. We used linear regression to look for an association between hospital score in each domain and 30-day readmission rate.
Results: Surveyed sites were 28% academic and 61% community hospitals. The readmission rates were comparable to the national average (median IQR 24.0% [22.6-25.7]). We found no associations between either inpatient care processes or quality improvement domains and 30-day readmission rates. Hospitals that exceeded standard in the discharge/transitions of care domain had a non-significant trend toward improved readmission rates (P=0.1) (Table). As measured by continuous scores within each domain, hospitals with better discharge processes/transitions of care were associated with lower 30-day readmission rates (P=0.019).
Conclusions: Performance on inpatient HF care or hospital quality improvement processes by survey showed no clear association with short-term readmission rates. Hospitals reporting more complete discharge and transitional care processes had lower 30-day readmission rates. Further studies are needed to identify strategies for hospitals to reduce HF readmissions.
- © 2011 by American Heart Association, Inc.