According to a study published by the Journal of the American College of Cardiology in early August, patients who are hospitalized for heart failure face vastly different readmission rates depending on the length of their stay.
The study found that shorter stays were associated with higher rates of hospital readmission rates for cardiovascular conditions, but lower rates of non-cardiovascular readmissions. Conversely, patients who experienced longer stays faced increased hospital readmission rates of all types, in addition to an increased rate of mortality.
Approximately 20 percent of all discharged patients are readmitted within 30 days, the study states, but approximately 25 percent of patients diagnosed with heart failure are readmitted within the same window. Heart failure is considered to be a leading cause of both initial hospital admission and readmission within 30 days.
Hospitals with Highest Heart Failure Readmission Rate
| Hospital | Heart Failure Readmission Rate | Heart Failure Mortality Rate | Avg Length of Stay |
|---|---|---|---|
| Harlan ARH Hospital | 30.4% | 12.4% | 3.4 |
| Brooklyn Hospital Center at Downtown Campus | 28.7% | 11.4% | 5.4 |
| NYC Health and Hospitals - Harlem | 28.1% | 11.9% | 4.4 |
| Newark-Wayne Community Hospital | 27.4% | 10.5% | 3.9 |
| St Lucie Medical Center | 27.2% | 13.7% | 4.2 |
| St Bernard’s Medical Center | 27.1% | 15.9% | 4.7 |
| DMC Sinai - Grace Hospital | 27.0% | 9.1% | 4.5 |
| Baptist Easley Hospital | 26.8% | 12.7% | 3.7 |
| Forrest General Hospital | 26.7% | 12.5% | 4.5 |
| Mercy Hospital - Jefferson | 26.7% | 10.3% | 5.4 |
Fig 1 Data from Definitive Healthcare data using the most recent available CMS reports.
Length of stay could directly influence patient readmission risk and is also explicitly related to hospital and payor costs. With a CMS emphasis on decreasing hospital readmission rates, including penalties for hospitals that don’t perform well, care centers and providers are encouraged to reduce length of stay in terms of bundled payment options as well.
According to the most recent available CMS data, readmission costs total about $41 billion in healthcare spending every year. However, CMS spending did fall by more than $9 billion from 2011 to 2014.
Along with decreasing length of stay for heart failure patients comes the concern that patient needs may not be properly assessed or met after discharge. Though shorter length of stay is linked to lower mortality, it still correlates to a high cardiovascular readmission rate. If a heart failure patient is discharged too early there is the risk of receiving inadequate care for pulmonary or peripheral edemas, leading to oversight in terms of which patients require additional care post-discharge.
Hospitals with Lowest Heart Failure Readmission Rate
| Hospital | Heart Failure Readmission Rate | Heart Failure Mortality Rate | Avg Length of Stay |
|---|---|---|---|
| Lancaster General Hospital | 15.5% | 10.1% | 4.0 |
| Oklahoma Heart Hospital | 15.8% | 9.3% | 4.4 |
| McKay-Dee Hospital Center | 16.6% | 13.3% | 3.8 |
| Intermountain Medical Center | 17.0% | 12.3% | 4.7 |
| St Francis - Downtown | 17.2% | 13.2% | 4.5 |
| Mission Hospital - Memorial Campus | 17.2% | 10.6% | 5.1 |
| Bryan Medical Center - East | 17.2% | 15.6% | 5.1 |
| Kootenai Medical Center | 17.3% | 15.4% | 4.2 |
| Santa Barbara Cottage Hospital | 17.3% | 10.5% | 4.7 |
| Mercy Hospital - Washington | 17.3% | 10.7% | 3.0 |
Fig 2 Data from Definitive Healthcare data using the most recent available CMS reports.
An additional factor in patient length of stay was patient age; older patients were more likely to be hospitalized for longer periods of time and have additional chronic illnesses that could lead to complications. Older patients with multiple health issues are generally at a higher risk for complications, infections, and relapse.
The study concludes that it is essential that care providers balance heart failure length of stay to ensure patients receive necessary care in a relatively short period of time to reduce the risk of mortality or readmission.
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