The association between hospital readmission and insurance provider among adults with asthma.
BACKGROUND
Asthma is ranked as the ninth most common chronic condition in the U.S., and its annual direct costs from hospital services alone are estimated at $3.1 billion. Hospitalization rates due to asthma reveal several disparities and may be attributed to recent changes in the healthcare delivery system, including the penetration of managed care.


OBJECTIVE
To examine the relationship between 7-day hospital readmission and insurance provider among adults with asthma. DDESIGN: A retrospective cohort study that included patients aged 18-64 with a principal diagnosis of asthma, who were discharged from acute nonfederal hospitals in New Jersey between 1 January 1993 and 31 December 1996. In the absence of unique patient identifiers, a linkage system was used to match subsequent readmissions for the same patient to the first admission. MMAIN OUTCOME MEASURE: Seven-day readmission.


RESULTS
Results showed a significantly increased risk of 7-day readmission for managed care patients as compared to indemnity patients (OR= 1.67, 1.10-2.53). Shorter lengths of stay were associated with greater odds of readmission (LOS=0: OR=5.17, 2.49-10.75, LOS=1: OR=2.30, 1.30-4.07).


CONCLUSIONS
Managed care patients have shorter lengths of stay as compared to indemnity patients, which leads to an increased risk of returning to the hospital within a short period of time. In trying to provide cost-effective patient care, we may be discharging patients prematurely.
Ather
Shabana
S
Department of Epidemiology, University of Medicine and Dentistry of New Jersey--School of Public Health, Piscataway, New Jersey 08854-5635, USA.
Chung
Katherine D
KD
Gregory
Patrice
P
Demissie
Kitaw
K
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001249:Asthma / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D015331:Cohort Studies; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007350:Insurance, Hospitalization / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data*; D012016:Reference Values; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States