Trends in 30-Day Readmission Rates for Patients Hospitalized With Heart Failure: Findings From the Get With The Guidelines-Heart Failure Registry.
Reducing hospital readmissions for patients with heart failure is a national priority, and quality improvement campaigns are targeting reductions of ≥20%. However, there are limited data on whether such targets have been met.



We analyzed data from the American Heart Association's Get With The Guidelines-Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. A total of 21,264 patients with heart failure were included from 70 US sites from January 2009 to October 2012. Overall hospital-level, risk-adjusted, 30-day all-cause readmission rates declined slightly, from 20.0% (SD, 1.3%) in 2009 to 19.0% (SD, 1.2%) in 2012 (P=0.001). Only 1 in 70 (1.4%) hospitals achieved the 20% relative reduction in 30-day risk-adjusted readmission rates. A multivariable linear regression model was used to determine hospital-level factors associated with relative improvements in 30-day risk-adjusted readmissions between 2009 and 2012. Teaching hospitals had higher relative readmission rates as compared with their peers, and hospitals that used postdischarge heart failure disease management programs had lower relative readmission rates.



Although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Kristin E
KE
Bergethon
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Christine
C
Ju
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Adam D
AD
DeVore
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
N Chantelle
NC
Hardy
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Gregg C
GC
Fonarow
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Clyde W
CW
Yancy
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Paul A
PA
Heidenreich
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Deepak L
DL
Bhatt
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.).
Eric D
ED
Peterson
From the Duke Clinical Research Institute (K.E.B., C.J., A.D.D., N.C.H., E.D.P., A.F.H.) and Department of Medicine (A.D.D., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Ahmanson-University of California at Los Angeles Cardiomyopathy Center, University of California (G.C.F.); Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.); Veterans Affairs Palo Alto Health Care System, CA (P.A.H.); Stanford University, CA (P.A.H.); and Brigham and Woman's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (D.L.B.). adrian.hernandez@duke.edu.
Adrian F
AF
Hernandez
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence / Q000639:trends*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006784:Hospitals, Teaching / Q000639:trends; D006801:Humans; D016014:Linear Models; D008297:Male; D006278:Medicare / Q000639:trends; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000639:trends*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D058996:Quality Improvement / Q000639:trends; D019984:Quality Indicators, Health Care / Q000639:trends; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D014481:United States
attention; heart failure; hospitalization; inpatient; outpatient