Two infectious conditions common in long-term care settings — septicemia and urinary tract infections — were among the top causes of hospital readmissions for Medicare beneficiaries in 2011, according to recently released data.
Septicemia, a type of blood infection, accounted for 92,900 readmissions within 30 days of hospital discharge, analysts with the Healthcare Cost and Utilization Project determined. This made it the No. 2 cause of readmissions for Medicare patients, behind non-hypertensive congestive heart failure.
Urinary tract infections ranked No. 6, with 56,900 readmissions, according to the HCUP figures.
Hospitals currently face reduced Medicare reimbursements if they have high readmissions linked to three conditions: congestive heart failure, pneumonia and acute myocardial infarction. Pneumonia and acute infarction ranked No. 3 and No. 8, respectively, on the HCUP list. While previous research has shown these conditions are common causes of readmissions, this is the first HCUP statistical brief to break down causes by payor type. The data does not indicate what proportion of readmissions might have been preventable.
The government has said it will start considering additional conditions when calculating 2015 hospital readmissions penalties. As Affordable Care Act policies have encouraged acute and post-acute partnerships, nursing homes and rehabilitation centers have been motivated to reduce the number of patients they send back to the hospital, particularly for conditions linked to penalties.
Skilled nursing facilities themselves will see Medicare payments tied to “all-cause, all-condition” hospital readmissions starting in 2018, under legislation passed earlier this month.
Overall, there were 3.3 million readmissions in 2011, and Medicare patients accounted for 56% of them, according to HCUP.
The HCUP information was drawn from a database created for the project utilized by 18 states. The states accounted for nearly half the U.S. population, and the data set included 14 million discharges.
HCUP is a federal-state-private industry partnership sponsored by the Agency for Healthcare Research and Quality. Click here to access the complete April 2014 readmissions statistical brief.