News: Hospital readmissions down for stroke patients

CDI Strategies - Volume 12, Issue 37

The 30-day hospital readmission rate for stroke patients declined by an annual average of 3.3% from 2010 to 2014, MedPage Today reported. According to national data on more than two million stroke hospital discharges, about one in eight adult stroke patients were readmitted within 30 days of hospital discharge during that time period.

However, stroke patients discharged from high volume non-teaching hospitals were more likely to return than patients treated at high volume academic centers, according to the study published in the Journal of the American Medical Association (JAMA).

Reducing ischemic stroke readmissions is a CMS quality metric, but less is known about readmission rates for stroke patients who are covered by other insurers or the uninsured, or of patient who experiences hemorrhagic strokes, according to MedPage Today.

In the study, the researchers analyzed more than two million stroke events in the Nationwide Readmissions Database of the Healthcare Cost and Utilization Project between January 1, 2010, and September 30, 2015, representing 50% of all hospitalizations in 22 states. Of these events, according to MedPage Today, 87.6% were acute ischemic strokes, 8.7% were intracerebral hemorrhages, and 3.6% were subarachnoid hemorrhages.

The researchers found that 13.7% of intracerebral hemorrhage patients, 12.4% of acute ischemic stroke patients, and 11.5% of subarachnoid hemorrhage patients were readmitted within 30 days.

While teaching hospitals had steady readmission rates on average regardless of how many stroke patients they treated, non-academic centers had higher readmission rates with increasing numbers of stroke patients, MedPage Today reported. The researchers point out that high-volume teaching hospitals are more likely to participate in stroke quality data registries and they may be more likely to be accredited stroke centers, which may lead to lower readmission rates.

While the researchers concluded that their findings may serve as a basis for evaluation and revision of readmission reduction strategies at the level of individual hospitals, further study is needed to fully develop nationwide readmission reduction strategies.

Editor’s note: To read MedPage Today’s coverage of this story, click here. To read the complete study from JAMA, click here. To read a recent Q&A on using the National Institutes of Health Stroke Scale, click here. To read about recent Coding Clinic advice related to strokes, click here.

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Clinical & Coding, News, Quality