Abstract 15694: Readmissions After Acute Myocardial Infarction: How Often Do Patients Return to the Discharging Hospital?
Background: While initiatives have focused on reducing 30 day readmission after myocardial infarction (MI), little is known about readmission location. We hypothesized that patients readmitted to the discharging (index) vs. a non-index hospital differ in characteristics, reasons for readmission and outcomes.
Methods: We examined 53,478 Medicare patients ≥65 years discharged home alive post-MI at 491 US hospitals in ACTION Registry-GWTG, excluding patients residing >100 mi from the index hospital. We compared readmission location, diagnosis codes and length of stay (LOS) between patients readmitted to the index vs. non-index hospital within 30 days of discharge.
Results: Among 7,716 readmitted patients, 2,109 (27%) were readmitted to a non-index hospital. Patients readmitted to a non-index hospital were similar in age (median 76 vs. 77) and sex (48 vs. 50% female), but were more likely transferred in during the index admission (68 vs. 16%, p<0.01), and discharged from an academic hospital (34 vs. 24%, p<0.01) than patients readmitted to the index hospital. Readmission rates for conditions similar to or sequelae of the index MI did not differ between patients readmitted to the index vs. non-index hospital (Table). Overall, the median LOS (25th, 75th %iles) of the readmission was similar between patients readmitted to the index vs. non-index hospital: 4 days (2,6) vs. 3 days (2,6), p=0.16. One in 5 patients readmitted to a non-index hospital required transfer for continued care; of these: 89% returned to the index hospital. Among patients readmitted to a non-index hospital, the median LOS was 3 days (2,5) for patients who stayed, and 5 days (3,8) for patients who were transferred.
Conclusions: The majority of MI patients returned to the index hospital if readmitted. Readmissions for conditions related to the index hospitalization did not differ by readmission location. Readmission to a non-index hospital was not associated with longer LOS unless transfer occurred.
Author Disclosures: J. Rymer: None. A.Y. Chen: None. L. Thomas: None. J. Stafford: None. J. Garvey: None. G. Fonarow: Research Grant; Modest; NIH/NINR – 1R01 NR013625. E. Peterson: Research Grant; Modest; Janssen, Eli Lilly. Consultant/Advisory Board; Modest; Astra Zeneca, Merck, Janssen, Boehringer Ingelheim, Bayer. T. Wang: Research Grant; Modest; Gilead Sciences, Eli Lilly, Daiichi Sanyo, Astra Zeneca, Boston Scientific, Regeneron, GlaxoSmithKline. Honoraria; Modest; Astra Zeneca, Eli Lilly, Pfizer.
- © 2016 by American Heart Association, Inc.