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J Asthma. 2004 Oct;41(7):709-13.

The association between hospital readmission and insurance provider among adults with asthma.

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  • 1Department of Epidemiology, University of Medicine and Dentistry of New Jersey--School of Public Health, Piscataway, New Jersey 08854-5635, USA.

Abstract

CONTEXT:

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.

PMID:
15584629
[PubMed - indexed for MEDLINE]
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