TY - JOUR
T1 - Readmissions of adults within three age groups following hospitalization for pneumonia
T2 - Analysis from the Nationwide Readmissions Database
AU - Jain, Snigdha
AU - Khera, Rohan
AU - Mortensen, Eric M.
AU - Weissler, Jonathan C.
N1 - Publisher Copyright:
© 2018 Jain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/9
Y1 - 2018/9
N2 - Background While 30-day readmissions following hospitalization for pneumonia have been well-studied in the elderly, their burden in young adults remains poorly understood. Objective To study patterns of readmissions following hospitalization for pneumonia across age groups and insurance payers. Methods In the Nationwide Readmission Database for the years 2013 and 2014 we identified all adults (18 years) discharged alive after a hospitalization with the primary diagnosis of pneumonia, and examined rates of readmissions within 30-days of discharge. Using covariates included in the Center for Medicare & Medicaid Services risk-adjustment model for pneumonia readmissions in a multivariable regression model for survey data, we identified predictors of 30-day readmission. Results We identified 629,939 index pneumonia hospitalizations with a weighted estimate of 1,472,069 nationally. Overall, 16.2% of patients were readmitted within 30 days of their hospitalization for pneumonia, with 30-day readmission rates of 12.4% in the 18–44 year age-group, 16.1% in the 45–64 year age-group, and 16.7% in the 65-year age-group. In risk-adjusted analyses, compared with elderly, middle-aged adults were more likely to be readmitted (risk-adjusted OR 1.05, 95% CI 1.03–1.07). Mean cost per readmission was also highest for this age group at $15,976. Conclusion Middle-aged adults experience substantial rates of 30-day readmission that are comparable to those over 65 years of age, with a higher cost per readmission event. Future efforts are needed to identify potential interventions to alleviate the high burden of pneumonia readmissions in middle-aged adults.
AB - Background While 30-day readmissions following hospitalization for pneumonia have been well-studied in the elderly, their burden in young adults remains poorly understood. Objective To study patterns of readmissions following hospitalization for pneumonia across age groups and insurance payers. Methods In the Nationwide Readmission Database for the years 2013 and 2014 we identified all adults (18 years) discharged alive after a hospitalization with the primary diagnosis of pneumonia, and examined rates of readmissions within 30-days of discharge. Using covariates included in the Center for Medicare & Medicaid Services risk-adjustment model for pneumonia readmissions in a multivariable regression model for survey data, we identified predictors of 30-day readmission. Results We identified 629,939 index pneumonia hospitalizations with a weighted estimate of 1,472,069 nationally. Overall, 16.2% of patients were readmitted within 30 days of their hospitalization for pneumonia, with 30-day readmission rates of 12.4% in the 18–44 year age-group, 16.1% in the 45–64 year age-group, and 16.7% in the 65-year age-group. In risk-adjusted analyses, compared with elderly, middle-aged adults were more likely to be readmitted (risk-adjusted OR 1.05, 95% CI 1.03–1.07). Mean cost per readmission was also highest for this age group at $15,976. Conclusion Middle-aged adults experience substantial rates of 30-day readmission that are comparable to those over 65 years of age, with a higher cost per readmission event. Future efforts are needed to identify potential interventions to alleviate the high burden of pneumonia readmissions in middle-aged adults.
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U2 - 10.1371/journal.pone.0203375
DO - 10.1371/journal.pone.0203375
M3 - Article
C2 - 30212485
AN - SCOPUS:85053282695
SN - 1932-6203
VL - 13
JO - PloS one
JF - PloS one
IS - 9
M1 - e0203375
ER -