Background:
Readmission rates are becoming an important quality and reimbursement metric in our health care system. Hospitalists are held accountable for patients who require premature readmission. Little is known about the impact of hyponatremia (HN) on inpatient readmission rates, even though HN is the leading electrolyte abnormality among hospitalized patients. This study was designed to evaluate the impact of HN on readmission rates among hospitalized patients.
TABLE Rehospitalization Rates for HN and non‐HN Cohorts 30 and 180 Days Postdischarge
Methods:
This retrospective analysis examined inpatient readmissions among HN patients discharged from more than 450 hospitals using the Premier Perspective® database. The population for this analysis included inpatients with HN as a primary or secondary diagnosis who were discharged between January 2007 and June 2009. Patients transferred to/from another acute care facility, patients who left against medical advice, and labor/delivery patients were excluded from this analysis. HN patients (n = 564,723) were matched to a non‐HN control using exact matching on age, sex, provider region, and 3M™ APR‐DRG assignment. Matching was further refined using propensity scores on other patient and hospital characteristics and patient comorbidities. Statistical analyses were conducted using chi square or Fisher's exact probability.
Results:
Hospital demographics were similarly distributed across both cohorts. Sixty‐seven percent of patients were white, with 75% admitted through the emergency room, and 49.8% discharged home. Approximately 56% had a primary payer of traditional Medicare, whereas nearly 48% fell into the major severity of illness category. Patients with HN had a significantly higher readmission rate, both short term and long term, than patients who did not have HN.
Conclusions:
HN has a significant impact on the rate of all‐cause and all primary diagnosis HN‐related inpatient rehospitalization rates 30 and 180 days postdischarge. The primary or secondary diagnosis of HN is a risk factor for readmission of hospitalized patients. By identifying that HN patients are being readmitted frequently, an organization may have an opportunity to reduce this rate and improve outcomes by improving discharge planning and patient education and increasing the availability of outpatient/home health services.
Disclosures:
S. Deitelzweig ‐ Otsuka, research funding, speakers bureau; A. Amin ‐ Otsuka, research funding, speakers bureau; J. Lin ‐ Otsuka, consultant; D. Baumer ‐ Otsuka, Consultant; K. Belk ‐ Otsuka, consultant