Hospitals struggling to reduce 30-day readmissions can gain insights from a new federal report that lists the top conditions associated with approximately 3.3 million readmissions in 2011.

The report, from the Agency for Healthcare Research and Quality, also analyzes how conditions vary depending on insurance coverage. Researchers used readmissions data from AHRQ’s Healthcare Cost and Utilization Project, which is a set of healthcare databases and tools. Readmissions in 2011 contributed $41.3 billion in total hospital costs. The study covered Medicare beneficiaries aged 65 and older, and individuals aged 18-64 who were privately insured, covered by Medicaid or uninsured.

Medicare by far had the largest number of readmissions with 55.9 percent of the total, and 58.2 percent of associated costs. Medicaid had 20.6 percent of readmissions and 18.4 percent of costs; private insurance accounted for 18.6 percent of readmissions and 19.6 percent of costs; and the uninsured covered 4.9 percent of admissions and 3.7 percent of costs.

Overall, the readmission rates per 100 admissions were 17.2 for Medicare, 14.6 for Medicaid, 8.7 for privately insured and 10.6 for uninsured.

The 10 most common conditions associated with 30-day readmissions for Medicare patients in 2011 were congestive heart failure at 7.3 percent; septicemia (excluding labor ) at 5.1 percent; pneumonia (excluding caused by TB or STD) at 4.8 percent; chronic obstructive pulmonary disease and bronchiectasis at 4.2 percent; cardiac dysrhythmias at 3.8 percent; urinary tract infections at 3.1 percent; acute and unspecified renal failure at 2.9 percent; acute myocardial infarction at 2.8 percent; complication of device (implant or graft) at 2.6 percent; and acute cerebrovascular disease at 2.5 percent. In total, these 10 conditions accounted for 39.1 percent of Medicare 30-day readmissions in 2011.

The report, available here, also has Top 10 listings for readmissions of Medicaid, privately insured and uninsured patients. The top condition in each category was mood disorders for Medicaid; maintenance chemotherapy/radiotherapy for privately insured; and mood disorders for uninsured.

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