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Association between unplanned readmission to a different hospital and all-cause mortality among older patients with ischemic heart disease: A nationwide claim study

  • Yeong Jun Ju
    Affiliations
    Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea

    Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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  • Hoo-Yeon Lee
    Affiliations
    Department of Social Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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  • Sang Ah Lee
    Affiliations
    Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea

    Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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  • Jaeyong Shin
    Affiliations
    Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea

    Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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  • Eun-Cheol Park
    Correspondence
    Corresponding author at: Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
    Affiliations
    Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea

    Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea

    Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
    Search for articles by this author
Published:January 19, 2018DOI:https://doi.org/10.1016/j.ejim.2018.01.017
      Up to one-third of patients are readmitted to a different hospital although it is unclear whether the readmission site affects subsequent outcomes. For example, although most patients are readmitted to the original hospital, a substantial proportion of patients are readmitted to a different hospital (16.7–29.3%) [
      • Kim H.
      • Hung W.W.
      • Paik M.C.
      • Ross J.S.
      • Zhao Z.
      • Kim G.-S.
      • et al.
      Predictors and outcomes of unplanned readmission to a different hospital.
      ,
      • Kind A.J.
      • Bartels C.
      • Mell M.W.
      • Mullahy J.
      • Smith M.
      For-profit hospital status and rehospitalizations at different hospitals: an analysis of Medicare data.
      ,
      • Saunders R.S.
      • Fernandes-Taylor S.
      • Kind A.J.
      • Engelbert T.L.
      • Greenberg C.C.
      • Smith M.A.
      • et al.
      Rehospitalization to primary versus different facilities following abdominal aortic aneurysm repair.
      ]. Readmission to different hospitals can contribute to care fragmentation, which is concerning because the original hospital is more likely to understand the patient's needs and develop a care plan. In contrast, the new hospital may have limited access to the patient's medical records, which could delay appropriate diagnosis and/or treatment, and subsequently affect the quality of care and risk of mortality [
      • McAlister F.A.
      • Youngson E.
      • Kaul P.
      Patients with heart failure readmitted to the original hospital have better outcomes than those readmitted elsewhere.
      ,
      • Staples J.A.
      • Thiruchelvam D.
      • Redelmeier D.A.
      Site of hospital readmission and mortality: a population-based retrospective cohort study.
      ]. In addition, readmission to a different hospital is associated with increased medical costs, compared to readmission to the original hospital [
      • Dahl C.M.
      • Kongstad L.P.
      The costs of acute readmissions to a different hospital–does the effect vary across provider types?.
      ]. However, one study failed to detect significant differences in adverse outcomes, including mortality, among patients who were readmitted to the original or a different hospital [
      • Kind A.J.
      • Bartels C.
      • Mell M.W.
      • Mullahy J.
      • Smith M.
      For-profit hospital status and rehospitalizations at different hospitals: an analysis of Medicare data.
      ]. Thus, additional studies are needed to examine the association between unplanned readmission to a different hospital and patient outcomes. The present study examined the association between unplanned readmission site and 30-day all-cause mortality among patients with IHD.

      Keywords

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