Hospital Readmission Rates in U.S. States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster?
This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions.



The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to contextual and provider data from Health Resources and Services Administration. A multivariate cross sectional design at primary care service area (PCSA) level is used.



Adjusting for area characteristics, the readmission rates were significantly higher in PCSAs having higher proportions of patients with 2-3 chronic conditions and those with 4+ chronic conditions, compared with areas with a higher concentration of patients with 0-1 chronic conditions.



Using small area analysis, the study shows that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
Agency for Health Care Research and Quality, Center for Evidence and Practice Improvement, Rockville, MD.
Jayasree
J
Basu
School of Public Health, Department of Health Services, University of Washington, Seattle, WA.
Rosa
R
Avila
Agency for Health Care Research and Quality, Center for Evidence and Practice Improvement, Rockville, MD.
Richard
R
Ricciardi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D062305:Geographic Mapping; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071069:Multiple Chronic Conditions / Q000453:epidemiology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016270:United States Agency for Healthcare Research and Quality / Q000706:statistics & numerical data
Hospital readmissions; U.S. states; comorbidities; multiple chronic conditions; small area analysis